Two years post op - Did Septoplasty cause a bifid nasal tip? (Photos)

Question

I’m 41 and received a septoplasty 2 years ago. The tip of my nose was deviated. I noticed one year post op there was a split in my nose. It looks like a bifid tip, my nose has a “butt” shape now. The tip of my nose was always round but never had those indents. An ENT did my surgery and when I followed up the other day with my concerns he said due to age the shape is changing. I was insecure about my nose prior to the procedure but now it’s way worse. Is it possible this happened due to the surgery? I feel like it did. I want it fixed but I don’t think insurance will cover this.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It would really depend on the specific techniques used by your surgeon during your surgery. Based on your photographs, you are a great candidate for a revision rhinoplasty. Maneuvers for your surgery would include nasal tip deprojection, placement of mastoid fascia tip graft for a smoother tip contour, among other maneuvers. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Yasemin Aydinli, MD · Answer

I am sorry you are dealing with this &mdash; feeling worse about your nose after a procedure meant to help is truly distressing, and your concern is understandable. To answer your main question honestly: a true septoplasty performed entirely inside the nose to straighten the septum does not usually change the external shape of the tip. However, when the caudal (front) part of the septum is addressed, or if any work approached the tip, changes in tip support can occasionally show up over the following months, so it is at least possible the surgery played a role. Your ENT's point about aging is also partly fair &mdash; tip cartilages can separate and show definition as the overlying skin thins with time &mdash; but the timing you describe, appearing within a year of surgery, makes it reasonable to wonder whether the two are connected.
A bifid or "split" tip appearance comes from the two lower lateral (tip) cartilages sitting apart with insufficient connection or support between them, which can let a central groove or indentations show through the skin. The good news is that this is very fixable: a tip refinement, usually through rhinoplasty, can bring the cartilages together with sutures and, where needed, a small cartilage graft to smooth and support the tip into a single, rounded shape. Because you mentioned you were already self-conscious about your tip, this is also an opportunity to refine it to what you have always wanted.
I am not able to comment on whether your insurance would cover this, because that depends on the rules and conditions in your own country, which I do not know. What I can tell you is that a consultation is the right place to get a clear plan and an honest cost estimate. The best next step is an in-person exam where I can assess your tip cartilages, skin thickness, and current support, and show you with imaging what a correction could achieve.

Two years post op - Did Septoplasty cause a bifid nasal tip? (Photos)

Answers (2)

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