What is the Best Way to Fix Pollybeak Deformity?

Question

About 8 months ago, I went in for a rhinoplasty, and eventually a pollybeak deformity revealed itself. My surgeon denies that exact term, but recognizes that I dislike the prevalent hump that remains on the supratip of my nose.

	He is willing to fix it, but I need advice on the right way of going about the revision. Please read the review I submitted here, and take a look at the pictures as well. I would greatly appreciate any input I can gain: Rhinoplasty - Treatment Review

John Diaz, MD · Answer

The polly beak deformity may be caused by various problems. The causes and the possible solutions, are listed below.
1. Excess scar tissue: can be improved with steroid injections. If steroid injections don't work, you may need another minor procedure to remove the scar.
2. Not having the top of the septal cartilage lowered enough: The only way to fix this is to undergo another procedure. The excess cartilage can then be removed.
3. The tip dropping below the level of your profile: The solution is to redo the tip and provide more support so that it doesn't drop again.
4. The upper part of the nose was reduced too much AND the tip dropped: In addition to providing more support to your tip, as above, you will need a graft of cartilage placed on the upper part of the nose to raise the profile.

Catherine Winslow, MD · Answer

A supratip deformity like yours may be due to over-resecting bone, under-resecting cartilage or scar tissue formation. The latter is the easiest to fix- steroid injections like kenalog are usually all that is required. If you saw this develop progressively it may be due to scar tissue accumulation. Find a couple of experienced rhinoplasty doctors and get a couple of opinions before diving in to another surgery--it may not be necessary. 
Good luck.

Toby Mayer, MD · Answer

It appears that you do have a pollybeak deformity. What you call it is not as important as what you do for it.
You should see an experienced revision rhinoplasty expert to discuss with you the pros and cons of increasing your tip projection vs. lowering the supratip excess. It also appears that you might need a graft of the bridge, but the photos are not good enough to tell..

What is the Best Way to Fix Pollybeak Deformity?

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What is the Best Way to Fix Pollybeak Deformity?

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