Is Adding Grafts to Nose Tip Safe?

Grafts can be quite effective at increasing definition in thick skinned patients. However, as was pointed out by several other surgeons, your result looks quite good in spite of your photos being from the immediate post operative period. I would caution you on trying to improve an already good result. You could suffer a complication or injury to your nasal skin during a fourth rhinoplasty. There are no guarantees and the risks go up with each surgery. Remember, there is no such thing as a perfect nose, no matter how many surgeries you get.

In most primary rhinoplasties, tip grafts are not needed unless the patient has thick skin, is a male, or if it is an ethnic rhinoplasty that needs sharper tip definition. In most cases, tip grafts add an additional risk for variability, resorption, and asymmetry long-term. I would advise against using tip grafts in most primary rhinoplasty patients.

Having tip cartilage grafts to the nose is a safe alternative, but it needs to be done for the correct reasons. Adding cartilage tip grafts to the nose will add width and bulk depending upon where they are placed. Full healing takes a year for all of the swelling to subside, so this is not an operation that is done lightly. Thick skin will need to be addressed many times in the postoperative phase in ethnic rhinoplasty by placing cortisone injections into the supratip area in an effort to resolve some dermal fibrosis, scar tissue and edema that tends to heap up after surgery.