Can a third Rhinoplasty correct my polly beak? (photos)

Question

I developed polybeak after my first rhinoplasty, and then once again after my second rhinoplasty. Can it be corrected? Also, can my long nose be shortened? I want a small straight nose. I dont like how my tip dips below my nostrils. Can that be fixed?

Bahman Guyuron, MD · Answer

Polly beak deformity results from not having enough tip projection, scar formation or residual cartilage above the tip. Not having full front, profile and head tilted back views of your full face makes a precise judgement about you nose difficult. You may benefit from augmentation of your bridge, increase in tip projection and removal of scar tissues above the tip, use of supratip suture that I have published article about and perhaps injection of cortisone at the time of surgery. Taping the nose after surgery also helps.You may wish to consult a plastic surgeon who has experience with this type of nose.

Brock Ridenour, MD · Answer

Because your nasal skin is still healthy, you are an excellent candidate for revision rhinoplasty.  The correction of pollybeak depends on its underlying cause(s) but typically requires a reduction of cartilage from the lower portion of the nasal bridge and the elimination of post-operative "dead space" (space between the skin and the nasal framework). Internal sutures, taping of the nose, control of bleeding, and steroid injections all help to adapt the skin to the nose and limit scar tissue, which can contribute to pollybeak deformity. Adding cartilage to the upper portion of the nose is sometimes helpful in certain patients to balance the profile and help distribute excess skin. Good luck

Jose Barrera, MD · Answer

Revision rhinoplasty can be done to correct the pollybeak deformity. Judicious taping and early treatment with intralesional steroids is recommended.

Michael T. Somenek, MD · Answer

The features that you are unhappy with can certainly be addressed with a revision rhinoplasty. The pollybeak formation that you have can be due to a couple factors. It is either due to inadequate removal of the cartilage that comprises that region of your nose or scar formation that can occur due to a variety of factors. Either way, the reason for this can be identified and addressed during the surgery. In the case of the projection of your nose, more photos would be helpful but in the ones that you submitted, it looks like the bridge of your nose could use some augmentation, or building up because it looks low in the profile photo. If augmented, this would add height to your profile and make your nose look less pronounced at the tip. You appear to have thick skin which has a tendency to have prolonged swelling and scar formation. Because of this, it is imperative that you follow up routinely with your rhinoplasty surgeon to ensure that if a problem arises, it can be addressed.

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