How to get rid of nasal tip bossae?

Question

I had rhinoplasty in 2009. Since then, my nose developed a bossae near the tip on the left side. It makes my nose look deviated to the left and longer in side view. Is there any way to get rid of it with applying pressure or massaging it? If surgery is required can it be done with a quick fix like just shaving the cartilage down? Or does a full blown revision rhinoplasty have to be done?

Kenneth Hughes, MD · Answer

A small revision can be performed to improve this appearance.  Kenneth Hughes, MDLos Angeles, California

Babak Azizzadeh, MD, FACS · Answer

Yes, you need full revision rhinoplasty and reconstruction of tip cartilages. Make sure you see a rhinoplasty expert who can address all of the issues you want to change during your revision surgery to achieve the best possible outcome.

Richard W. Westreich, MD · Answer

Hi there. Hard to tell from the picture if your tip issue is bossae or just a visible shield graft. Depending on your specific area of concern, filler could be of some use to camouflage the area. Alternatively you could do a minor revision using temporalis fascia or alloderm to add a layer of tissue over the bumps, which will smooth the contours and make them less visible or not visible at all. So there are options other than a full blown rhinoplasty. Best of luck In your search.

Tanveer Janjua, MD · Answer

The nasal bossae can be removed through a small incision through the nostril. The prominent part of the bossa is usually and cartilage that can be shaved. It is simple enough that you could get it done under local anesthesia. RegardsDr. JDisclaimer:
This answer is not intended to give a medical opinion and does not substitute
for medical advice. The information presented in this posting is for patients’
education only. As always, I encourage you to see your personal physician for
further evaluation of your individual case.

A. Joshua Zimm, MD · Answer

If you had rhinoplasty done in 2009, a revision rhinoplasty will be likely.  It may just require tip work, but that is something that would need to be evaluated in person at a formal rhinoplasty consult.  Massage and applying pressure will not work at this point.  You would be best served by seeing someone who specializes in facial aesthetic surgery, specifically rhinoplasty.  Best of luck.

Sean Freeman, MD · Answer

Nothappy411, most minor tip irregularities I fix under local anaesthesia. See an experienced facial plastic specialist and you should be satisfied. Good luck!

William Portuese, MD · Answer

To repair a nasal boss exploration of the nasal tip must be performed through marginal incisions on the inside of the nostril. Shaving down the boss is usually all that required by  your rhinoplasty surgeon. Occasionally suture technique  techniques must be performed on the lower lateral cartilages of the tip  to reconstitute them.  A closed rhinoplasty approach to accomplish your goals. For many examples of rhinoplasty, please see the link below

William B. Rosenblatt, MD · Answer

It is difficult to answer your question in looking at that photo. You need to be seen and evaluated. Maybe just re do your tip -- no one really knows until they see you in person.

Elliot W. Jacobs, MD · Answer

There are many changes that occur in a nose after rhinoplasty, often months to years later.  Some of those changes can be the development of scar tissue or alteration of the nasal contours and cartilages by the pull of scar tissue.  Only a consultation and examination by an expert in rhinoplasty can determine what is going on and how it might be fixed.Recommend you either return to your surgeon for a follow-up evaluation (if possible) or consider consulting with another plastic surgeon whose interests include rhinoplasty.  I would be pleased to meet with you to discuss possible treatment options.  Ca  212 570 6080 for an appointment.Elliot W. Jacobs, MD, FACSNew York City

Brooke R. Seckel, MD, FACS (retired) · Answer

Please consult and experienced or certified plastic surgeon who is expert at nasal revision after rhinoplasty.  The small bump area should be able to be corrected under local anesthesia.

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