Do I Have Pollybeak Deformity?

Question

Its 1 year and a half since surgery and i am still experiencing fullness and swelling in the tip region especially after drinking alcohol.Seeing my surgeon regularly and a few months ago we tried injections which didn't really help. I'm currently on anti Biotics incase its an infection. My surgeon said he wants to use revision as definet last resort as i could be one of these unlucky slow healers. My pictures of both my right and left side are below and just wondering if its swelling or polly?

Richard Parfitt, MD · Answer

Yes you do have "poly beak" deformity, which is the tell tail sign of a rhinoplasty done by a relatively inexperienced surgeon.  It is a relative prominence above the nasal tip with results from not taking down enough cartilage in this area and/or surgically releasing the tip support structures, without reconstructing that support before ending the surgery. In my opinion, the fact that the surgeon probably took too much bone down also contributes to the relative prominence of the cartilage above the tip.

	The good news is that this can be corrected in the hands of an experienced rhinoplasty surgeon.

Sam Naficy, MD, FACS · Answer

You do have slight pollybeak deformity as well as alar retraction which is greater on the right side - revision can improve all these features

Thomas A. Lamperti, MD · Answer

Being a year and a half after your nose surgery it's unlikely that the fullness is due to tissue swelling.

	You fullness could be from a few possible caues:

	
		Excess residual septal cartialge
	
		Prominent nasal tip cartilages
	
		Relative excess due to over-resection of the bridge above the supratip


	Visit with a revision rhinoplasty specialist to see what options you have.

Kevin Sadati, DO · Answer

Dear revision rhinoplasty patient from London,
	From limited view of your post rhinoplasty pictures, it appears that you have slight Polly-beak deformity. It requires a revision rhinoplasty to correct it. Being 18 months post op, it is an appropriate time to go ahead with a revision rhinoplasty. Good luck and good healing

Steven J. Pearlman, MD, FACS · Answer

A polly-beak deformity following Rhinoplasty is when the area just above the tip of the nose is the highest part of the nose when viewed in profile. This makes the nose look similar to a parrot beak (no insult intended). This can result from a number of causes. Determining the cause is the best way to decide how to fix it.

	1. Scar tissue just above the tip of the nose. 2. Upper third (hump or dorsum) was over-reduced. 3. Loss of tip support, the tip droops making the area just above it look to high. 4, The cartilage of the septum or upper lateral cartilages, that support the middle third of the nose, were left too high.

	To find out the best way to treat a polly beak deformity, please seek out a specialist in revision rhinoplasty.

Steven Wallach, MD · Answer

A pollybeak deformity occurs as a result of either unresected lower dorsal cartilage or excessive scar tissue and swelling that develops in the suptratip breakpoint. Just from the one view I see, it does not look like you have the pollybeak deformity. You may have an over-resected dorsum.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi Alex,

	From your pics it does look like you have a slight Pollybeak deformity. At this point, I would say that revision surgery is your only answer. It should be pretty straight forward. You need a little more cartilage taken off the top.

	Best,

	Dr.S.

Do I Have Pollybeak Deformity?

Answers (7)

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