Best Rhinoplasty Technique for Me

Hello. I have a very big nose and a bulbous tip I wonder what type of rhinoplasty fits or closed ? Will I need stenting

Doctor Answers 11

Best Technique to Improve a Large Bulbous Nose

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In my hands I would strongly recommend the open technique to reduce and refine your nose. I suggest you choose an experienced physician who specializes in rhinoplasty surgery because your very thick skin will limit what can be achieved. You will have significant improvement, but your surgeon must clearly establish reasonable expectations.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty type

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A bulbous tip may be addressed by an open rhinoplasty.  The soft tissues are gently elevated to allow direct access to the tip cartilages.  Tip cartilages are then sculped and sutured.

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon

Rhinoplasty techniques

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There are many techniques of rhinoplasty that are performed to refine the nose.  Most nasal surgery is performed through a closed technique whereby the tip cartilages are sewn together, narrowed, and refined through intradermal and interdermal approaches.  Osteotomies are performed to narrow the nasal bones.  Hump removal is performed to remove both the bone and cartilaginous hump.  When there are large nostrils, alarplasty is performed to reduce them in size.  Look for a surgeon who is an expert in rhinoplasty.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

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It is not technique but a surgeon's skill at technique that matters

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Choice of open or closed Rhinoplasty should be left to your Plastic Surgeon.  Patient should just  choose a skilled surgeon.  Choice of technique should be left to surgeon.  Patients are not capable of making that decision just from talking to their friends and browsing internet.

Outcomes from plastic surgery are directly determined by surgical skill and aesthetic acumen of your surgeon.  Surgeon's mastery of his favorite technique (open or closed does not matter) will determine the outcome.  Any surgical approach that is not backed by surgeon's skill will not deliver the result.  Plastic Surgery is an art and not mathemetical equation.  All art is unrestricted free form and needs a good artist in form of a skilled surgeon

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

The right technique in rhinoplasty. Open or closed?

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I have used both techniques over the years. There is no such thing as a right technique for a specific nasal problem. It is often the case to choose the right surgeon and let him/her choose the right technique. Thick skin is often a challenge in achieving an optimal result but good results can be achieved equally with closed and open techiniques. In my experience open technique is more usefull in tip revision surgery where extensive scarring poses an issue. In case of a bulbous nasal tip either open or clsoed technique is equally effective. The choice of technique should be made by the surgeon and not a web based poll or inquiry.

Julian Henley, MD
Greeley Facial Plastic Surgeon

Rhinoplasty Technique

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My preferred approach to redefining your nasal tip would be through a closed approach. I have treated many patients with bulbus tips and "thick skin" with this technique, and gotten good results

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Tip defining rhinoplasty in noses with thick skin

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I have achieved good nasal tip definition in noses with thick skin using medpor dorsal implants. This can be done via open or closed approach. An exam would be necessary to determine the exact surgical plan for you. While realistic expectations are important, you can certainly obtain natural, yet noticeable improvement!

Michelle R. Yagoda, MD
New York Facial Plastic Surgeon

External vs Endonasal approach (open vs closed) rhinoplasty

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There are different indications for external approaches for rhinoplasty. You are definitely a good candidate for an external approach. Thicker skin individuals will do well with an external approach as this affords access to both thin the skin and utilize more aggressive structural thinning techniques. Surprisingly the scars are minimal and barely visible after just a few weeks. Best Regards, Dr. Todd Hobgood

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews


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Certainly a rhinoplasty can be performed for you, but you have to be realistic with expectations for improvement. I fyou have thick oily skin, the tip may not be as refined as you might like.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Rhinoplasty technique

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Your tip size and shape would be best evaluated during surgery using the open approach.  You must understand that the final result from this procedure on any patient is dependent on several variables:  bone, cartilage, and skin.  From your photograph, the lower half of your nose appears to have moderately more skin thickness than most noses.  This type of skin is less amenable to visible contour improvement than thinner skin.  An analogy would be a sheet covering a mattress (one can see the mattress embossments) versus a thick quilt (which hides any irregularities in the mattress).  You may require cartilage grafts to better define your tip shape and projection.  You can certainly improve the shape of your nose with surgery, but the magnitude of change will be less than average.  Consult with several board certified plastic surgeons to understand these issues and their approach to your problem.

Ricardo Izquierdo, MD
Oak Brook Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.