Would I be a good candidate for a tip plasty? (photo)

Question

I've always wanted a rhinoplasty but I’ve never been sure what kind of results I should anticipate. Not happy about how boxy or bulbous my nasal tip. I have always been concerned that if I had a nose job it would make my nostril more exposed. would I be a good candidate for a tip plasty?

Andac Aykan, MD · Answer

Hello, thanks for your photos.
From the photos your bridge is looking already balanced, and the main concern is the bulbous, boxy tip. Tip refinement can narrow and define this area without over-rotating the tip or exposing the nostrils. You do look like a good candidate for a tip-focused rhinoplasty. 
A well-planned tip plasty should not make your nostrils more visible. The goal is controlled definition, not lifting the tip too much.
Andaç Aykan, MD, Assoc. Prof.

Donald Groves, MD · Answer

Hello and thank you for your question and the pictures. Addressing the shape of the nose (particularly the nasal tip) is actually one of the most common reasons people seek out and undergo a rhinoplasty. An open septorhinoplasty can best address your nose, and is particularly effective at addressing the tip size, shape, and definition! You would need a "full" rhinoplasty (instead of just working on the tip) because to properly balance your nose, and solidly reinforce the underlying framework to assure you get the BEST long term results (i.e. prevent nostril retraction and nose distortion), I would need to address your entire nose, not just your tip. Anyone who tells you otherwise is doing you a HUGE disservice!

This truly a surgery of millimeters- and it requires exceptional surgical skill to achieve natural-looking results! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading rhinoplasty experts (who performs 1,000+ nosejobs annually).

I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Kyle Kimura, MD · Answer

Great question and thank you for providing photos! 
A rhinoplasty can focus on whatever areas you are most concerned about, and if that is primarily the tip, this can often be accomplished without making other significant changes to other parts of the nose. Regarding your concern about the amount of nostril showing, I would make sure to address this with your surgeon during consultation because there are several maneuvers to either lower the edge of the nostril leading to less nostril show or maintain the same amount based on your preferences. 
I think one of the biggest challenges in your situation would likely be thicker nasal skin. This can sometimes make it difficult to see the changes made underneath the skin. There are several ways to address this but would best be addressed by your rhinoplasty surgeon during consultation.
Hope this helps!Kyle Kimura, MD

Luis A. Mejia, MD · Answer

Mr. Thoughful240127, thanks for sharing your concerns and pictures, this can be fixed and yes you look like a great candidate for tip plasty feel free to go into our instagram page or website for more information and references. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. It appears you have a straight, masculine dorsum but that your nasal tip is bulbous and in addition hangs slightly off your nasal septum and lacks projection.  Your nasal tip tissues also appear to be thick.  To refine your nasal tip shape and bring your nasal tip into balance and alignment with your nasal dorsum would require:  reshaping your nasal tip cartilages with sutures and then projecting and supporting your new nasal tip with a strong piece of cartilage such as a septal extension graft.  The nasal tip cartilages are sutured to the septal extension graft which slightly increases your nasal tip projection to bring it inline with your nasal dorsum and counteracts the backward/downward pull of your thicker nasal tip skin and the contraction of the healing process.  Have a detailed discussion with your plastic surgeon. Best wishes.

Tanveer Janjua, MD · Answer

You would get a good result from a combination of narrowing the nostrils (alarplasty) and narrowing the bulbous tip (tip-plasty)
Alarplasty is a very fine and quick procedure that can narrow the nostrils and reduce the flare to soften the appearance. It has other names as well like ‘Weir Excisions’ or ‘Nostril Reduction’. It can be done under local anesthesia.

Tip-plasty is a great procedure to address a bulbous tip only and leave the rest of the nose alone. It can be accomplished through an open or closed approach. The goal is to refine the tip and make it smaller and smoother. 
In tips with strong cartilages but thin skin, all that is needed is removing some of the cartilage and softening the rest by gently crushing it (morselizing). 
In tips with thick skin and lot of soft tissue or fat, the excess fat and soft tissue is removed along with removing some of the cartilage.
Click on the video link below.
Regards
Dr. J

Eric M. Joseph, MD · Answer

Based on your up-close photos, you appear to have a wide droopy nasal tip appearance, and this is associated with a profile dorsal hump. Rhinoplasty surgery may be considered for achieving a narrower nasal appearance, with a tip lift, and dorsal hump reduction, for a less distracting and masculine nasal appearance. I hope this helps! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers.. 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

Ronald J. Edelson, MD · Answer

Without addressing bump on the nasal bridge you will not get a good result.  You would need a full rhinoplasty. Doing the tip only would not be my recommendation

Gary M. Horndeski, MD · Answer

Your tip needs to be refined.  However, your dorsum is somewhat curved and you may need an extension graft that will provide more tip projection and give you linear contour on the dorsum.

Best Wishes,

Gary Horndeski, M.D.

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