What is the best option for nose refinement? Rhinoplasty? Tip Refinement? (Photo)

Nose is thick and bulbous. Would like a smaller, finer tip. What would be the best option?

Doctor Answers 3

What is the best option for nose refinement? Rhinoplasty versus tip refinement?

A full set of facial photographs that are in focus are required to make a determination about being a candidate for a rhinoplasty procedure. The far majority of patients must undergo a full rhinoplasty, not just the tip in order to make sure that the nose is balanced in a three-dimensional fashion. It's also important that all the components of the nose are balanced with each other, and the entire new nose is balanced with the patient's facial features. The bulbous tip is addressed with a conservative cartilage removal or suture techniques applied to the lower lateral cartilages of the nasal tip. Thick skin will be a significant impediment to seeing refinement in that area. For more information and many before-and-after examples, please see the link and the video below

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

What is the best option for nose refinement? Rhinoplasty? Tip Refinement?

Improving and refining the tip are frequent requests of patients wanting nasal refinement. It is possible to improve the cosmetic appearance of the tip alone without altering the rest of the nose in some patients. Whether the optimal option in your particular situation would be a tip rhinoplasty alone or an artistically performed natural appearing full rhinoplasty would best be determined at a consultation. Either procedure can be performed with a closed or open approach.

Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (ENT) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla,California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews


Thank you for your question and photographs.

It is important when looking for a plastic surgeon for Rhinoplasty to find one who is board certified and specializes in Rhinoplasty to obtain the best results possible.  To fully evaluate your nose, I would recommend that you schedule a consultation to have a full facial and nasal examination performed.  However, from what I can tell, it appears your tip is enlarged and bulbous. You would benefit from a tip rhinoplasty which includes trimming the lower lateral cartilages and placing precision sutures to refine the tip and make it look more pleasing and smaller in size and give you that sharper appearing nose. Best of luck in your endeavors!

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 79 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.