Can adding volume to the nasal tip make it look smaller? (Photo)

Question

Multiple rhinoplasties have resulted in my tip being poorly shaped (it makes my nose look overall long and over-resected.) The picture on the left is my ideal nose. It was taken during the healing process of one of my rhinoplasties. It looks natural, shorter, and has a more full tip. Is there a type of tip plasty that can help me achieve this ideal look?

Afshin Parhiscar, MD · Answer

Dear DunningkrugerIn order to have a more natural looking nose with the features you described, you would need a revision rhinoplasty. From the limited views you have shared, it appears your middle third is over-resected, and you have asymmetric osteotomies. You might benefit from revision of osteotomies, spreader grafts and an onlay temporalis fascia graft to soften the edges of cartilages so they wont show through your thin nasal soft tissue envelope.Look for an expereinced rhinoplasty surgeon who is certified by the American Board of Plastic Surgery. See more than one consult and take your tiem so you can make a well informed decision.

Peter Callan, MBBS, FRACS, MBA · Answer

Hi there and thanks for asking such perceptive questions.There is a bit going on here. At the moment you have asymmetry and I'm sure this reflects the underlying framework of the nose.  The question is can you breathe well?  If you can then it would be possible to just add filler to even things up a bit as a temporary measure, but in the long term you probably will need (yet another) rhinoplasty using graft material to reshape things.I'm sorry to tell you but it's a reasonably big operation and may need graft from outside the nose such as rib cartilage or soft tissues from under the scalp. However it is achievable. The only issue is the quality of the soft tissue envelope of the nose, which may hamper things a little, but can usually be overcome. I hope this helps.

Steven Wallach, MD · Answer

With repeated rhinoplasties, the soft tissues thin quite a bit and the cartilages often become weaker.  It can be difficult to fix.

William Portuese, MD · Answer

To obtain width in the mid portion and the tip of the nose requires cartilage grafting techniques accomplished through revision rhinoplasty.  Spreader grafts or extended spreader grafts harvested from inside the nose would be required to give added width to the mid portion of the nose. It's important to know whether or not there is any cartilage left on the inside of the nose for grafting purposes

Dennis Barek, MD (retired) · Answer

You had a deformity called "malposition of the alar cartilages" which was not recognized or not treated as it should have been.It the skin is pliable and not scarred down, septal cartilage grafts may help, but it looks like a difficult request, at this point.

Can adding volume to the nasal tip make it look smaller? (Photo)

Answers (5)

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