I'm 46 years old, noticing tip moving south as I age. Am I A Good Candidate For Nasal Tip Refinement? (photo)

Im 46 years old, noticing tip moving south as I age. Would I benefit from this procedure than a nasal rhinoblasty. I have a bump, however that doesnt bother me.. Im in excellent health, weight, non smoker/drinker.. however on med for BP.

Doctor Answers 18

Nasal tip refinement

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It is very rare that one needs only a nasal tip procedure performed.  In the far majority of cases the entire nose must be addressed at the time of rhinoplasty.  It is important to make sure all components of the nose is in balance with each other as well as other facial features.  There are several different techniques to lift, refine and feminize the nasal tip. Results should be in balance with the remainder of the nose, otherwise the patient would look unnatural.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Rhinoplasty Surgery

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It is possible to improve the appearance of the nasal tip with a rhinoplasty. I use computer imaging software in my office that allows me to morph a photo of the patient to predict the outcome of a surgical procedure.  This serves as a goal and a guideline for me to follow in the operating room.  I would recommend seeking a consultation with a board certified facial plastic surgeon who specializes in rhinoplasty. Sometimes, additional procedures may be necessary to ensure that your nose is balanced and compliments all of your facial features, but this really depends on the individual circumstances of the patient. Thank you, and I hope this helps.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews


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As long as your blood pressure is under good control and you have no other medical problems you appear to be a good candidate for nasal tip surgery

You can have nasal tip surgery without having surgery on your nasal dorsum

Refining and rotating your nasal tip can alter the appearance of your nasal dorsum without having any surgery on your dorsum.  Frequently, rotating your nose upward decreases the prominence of the nasal dorsum on a relative basis .  After tip surgery, it is possible that you will not appear to have any nasal dorsum prominence

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Am I A Good Candidate For Nasal Tip Refinement?

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From the photo, there's seems to be a small bump in the cartilage section of the nasal dorsum with an under-rotated nasal tip.  This can be addressed through a closed Rhinoplasty.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Correction of the drooping tip

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From the photos, it does appear that your tip has fallen some or has what we refer to as tip ptosis. Given your state of health, you certainly can have a limited tip-plasty to address the lower third of your nose or you can undergo a more complete rhinoplasty to correct or improve the entire nose depending upon your preferences.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Rhinoplasty for the drooping tip.

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Rhinoplasty for the droopy tip is one part of rhinoplasty. There Are several other parts that 

may be indicated  as well but I would need to see other photos. I only use your tissue--no foreign material.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Tip refinement rhinoplasty

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I think there is an improvement to be obtained on your tip. I would consider rotating it up slightly and a subtle refinement. Tip refinement surgery is a delicate task that requires much finesse but it can be quite rewarding.

Mark Samaha, MD
Montreal Facial Plastic Surgeon
4.9 out of 5 stars 97 reviews

Tip rhinoplasty

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Cosmetic rhinoplasty is like going to a restaurant. You do not have to eat everything on the menu and you do not have to get every area of the nose operated on. If you only want the tip done do the tip. If you want the tip and the bridge done do both it is a personal choice up to you. Some individuals have large dorsal humps in which case it does not make sense to only do the tip but even in these cases I have had patients that only want the tip work. One patient kept coming back to work on different areas because he could not see the utility of working on for example the bridge until the tip looked better.

Your posted photos show a drooping tip that droops further on smiling. The usual remedy is trimming the upper edges of the tip cartilages and dividing the muscles that come up from the lip to the nose. This allows the tip to rotate upward slightly and can be done with incisions only inside the nose (closed). If you wish further refinement with shaping sutures between the tip cartilages that is more reliably done open although it can be done closed. For most surgeons including myself it is better to put the shaping sutures in with an open approach. That will minimize the need for future revisions.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Tip rhinoplasty

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The short answer is yes, I believe this procedure would be beneficial to you. Your Facial Plastic Surgeon and you should look at your nose as a whole. To get the desired results you are looking for may not only require rotating and resupporting your tip but also changing the projection of your dorsum to match it. You appear to have what I call a plunging tip(which is accentuated when you smile) due to your tip cartilages overidding your dorsal support allowing it to fall. They are further pulled down when smiling due to an overactice depressor septae muscle. This can all be addressed surgically but I would advise you  not go into your consultation with a specific procedure in mind, just a specific result.

Von Graham, MD
New Orleans Facial Plastic Surgeon

Tip Rhinoplasty? Heck yeah!

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I see a nose that would do great with a tip rhinoplasty.  My preference would be to do this with an endonasal approach.  That means your incisions would be on the inside and you'd heal a little faster vs. an open approach.  However, there's nothing wrong with an open either.  It'll take a little longer to heal.

I do note a little bit thicker skin than average so you'll need to be a little patient with the result.  You don't want your surgeon's work to be too aggressive with cartilage removal or grafting.

Your goals of rotation and refinement are very achievable.  

Get several consults.  You've got a lot of great surgeons at your service in LA.

Good luck

Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.