Am I a candidate for closed rhinoplasty/tip plasty?

Question

I have never cared for my nose. From the front it is narrow and straight, which I am grateful for. I have a slight hump which also doesn’t bother me. My issue is with the long tip in profile, which is somewhat irregular in shape. It looks different from one side than the other. It also droops downward when I smile. I don’t feel I dislike it enough to risk a full open rhinoplasty. Could a tip plasty only benefit me?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Your nose may require improved tip support in order to prevent your nose from drooping when you smile.  Your nostrils can also be made smaller with rhinoplasty.  Nasal tip refinement and a cephalic rotation of your tip can be performed to turn
up your tip slightly.  Make
sure you specifically look at before and after pictures of real patients
who have had this surgery performed by your surgeon and not just a computer
animation system.  You should be able to
view numerous pictures of actual patients with noses similar to yours performed
by your surgeon.  If you cannot find
enough real before and after pictures, then consider continuing your search for
a surgeon. 
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Philip J. Miller, MD, FACS · Answer

I would recommend starting with a consultation with a board certified facial plastic surgeon that specializes in rhinoplasty surgery to discuss if rhinoplasty can address your concerns. 
I would recommend writing down the following questions before scheduling your consultation:
1. Are you unhappy with the tip of your nose? 
2. Do you feel that your nose is too wide? 
3. Do you want to make your nostrils smaller in appearance? 
4. Are you looking to decrease the general size of your nose?
I hope some of these questions will help you pinpoint what it is that you don't like about your nose.  Cost will vary due to various factors like anesthesia fees, facilities fees, etc. I wish you the best as you research your options when scheduling a rhinoplasty consultation.
Sincerely,
Philip J. Miller, MD, FACS Double Board Certified Facial Plastic Surgeon

Jonathan Kulbersh, MD · Answer

Your nose could be improved with rhinoplasty, which would give permanent improvements in symmetry and shape which could improve your tip. You can bring the pictures that you think would be flattering to your face and these can be discussed.  It takes special interest and study to understand the facial aesthetics to create a nose that is harmonious with your other features. Take the time to find the right facial plastic surgeon and ask them to create digital images of the nose they propose for you and discuss the cost.
Hope this helps.

Thomas Trevisani, MD · Answer

Fro the limited posted photos- it appears that you would benefit from Rhinoplasty preferably through closed technique. When changing one aspect of the nose - most likely all of the elements will have to be addressed. I recommend that you seek an experienced Board Certified PS for in person exam

Harry V. Wright, MD · Answer

You may very well be a candidate for a closed tip-plasty. It would ultimately depend on what your expectations are and that would take a much more in-depth conversation and examination. Tip-plasty can also be performed in an open fashion, and recovery is also much faster than that of a full open rhinoplasty. Even more important than the type of procedure is finding a Board-certified Facial Plastic Surgeon who you are comfortable with, who you trust, and go with their fully-informed recommendation to maximize your chances of a great outcome.Best wishes!  Harry V. Wright MD, Sarasota, Florida

William Portuese, MD · Answer

A closed rhinoplasty procedure can accomplish decreasing the projection of the nasal tip, making some minor adjustments to the nasal to cartilages, reduction of the dorsal hump, and reducing the hanging columella with all the incisions placed on the inside of the nose. No external incisions are required. For many before-and-after examples, please see the link and the video below to our closed rhinoplasty photo gallery

Robert Singer, MD · Answer

Improving the tip is a frequent
request of patients wanting nasal refinement. It is possible to improve the
cosmetic appearance of the tip alone without altering the rest of the nose in
some patients. Whether the optimal option in your particular situation would be
a tip rhinoplasty alone or an artistically performed natural
appearing full rhinoplasty would best be determined at a consultation.
Either procedure can be performed with a closed or open approach.
Following the advice from a surgeon on this or any other website who proposes
to tell you exactly what to do based on limited 2 dimensional photos without
examining you, physically feeling the tissue, assessing your desired outcome,
taking a full medical history, and discussing the pros and cons of the
operative procedure would not be in your best interest. I would suggest you
find a plastic surgeon with extensive nasal surgery experience who is certified
by the American Board of Plastic Surgery and ideally a member of the American
Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon
(otolaryngologist) that you trust and are comfortable with. You should discuss
your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California

Kailash Narasimhan, MD · Answer

Based on your concerns, you may be a candidate for a rhinoplasty limited to the tip. However often if the nose appears longer it is due to several factors not limited to just the tip.
Overall when we do rhinoplasty we want to achieve balance and harmony with all of the elements of the nose including the profile, the width of the nose, and the tip. The only way to have a proper evaluation of your concerns would be through an in person consultation.
Good luck,
Kailash Narasimhan, MD
Board certified in Plastic Surgery and ENT

Am I a candidate for closed rhinoplasty/tip plasty?

Answers (8)

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