Do I have a polly beak or just excessive soft tissue or scar tissue? (Photo)

I had a rhinoplasty over 2 years ago. Do I have a polly beak deformity or is my tip just too full (soft tissue or scar). I have very thick skin and if I have a polly beak deformity I definitely feel it is a soft tissue and scar tissue problem. Would steroids be an option to reduce the tip? Or fillers to bring my bridge up more so the tip doesn't look as large? I want to avoid surgery. Would this be a difficult revision though? Any helpful suggestions?

Doctor Answers 6

Revision Rhinoplasty Candidate

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Dear 22222, You have several issues going on with your current result. The bridge is over resected giving the nose a scooped appearance which is accentuated by the hanging columella and possible scar tissue in the tip of your nose. An examination would determine whether the concern you have with your tip is related to soft tissue swelling or residual cartilage. Depending on the desired look you want for your end result will determine the course of action needed.  Most likely you will require a revision rhinoplasty. Best regards, Michael V. Elam, M.D. 

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 214 reviews

Pollybeak deformity?

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Yes this is what you have plus a hanging columella and a slight scoop, etc.. These can all be repaired with a revision rhinoplasty done by a very experienced revision rhinoplasty surgeon. Look for examples on my website and others and look for a surgeon whose noses look natural after.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Do I have a poly beak deformity?

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From the limited photographs, it does appear that there is a Polly beak present in addition to a hanging columella. A thorough examination of the internal and next portion of the nose is required to determine what is causing the poly peak. Sometimes the poly because causing excessive soft tissue swelling, and sometimes it's cost from residual cartilage present. A revision rhinoplasty may be required  with close follow-up for steroid shots/ taping after the surgery. For more information and many  before-and-after examples of rhinoplasty, please see the link and the video below

Nasal tip

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Your nasal tip is missing refinement; this has to do with the shape that your lower cartilages were made into as well as soft tissue fullness in the supratip region. In order to determine which component is a larger contributor to your nasal tip shape, a consultation is necessary.

Rhinoplasty and polly beak

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The polly beak deformity is when the area above the tip of your nose (supratip) sticks out, which makes the tip of the nose appear to be hooking downward. 

You need a full consultation to learn what was performed in your surgery, to examine/feel your nose, assess your skin thickness, and to take photographs from multiple angles. If the fullness is scar tissue, injections with steroid or 5FU can improve it to a degree. Filler to the bridge would potentially make your nose look worse. Other issues require surgery to improve the shape. I would talk with your surgeon as well as meet with revision rhinoplasty surgeons. Take your time before starting any treatments. Safety comes first. 

Pollybeak vs under-resected dorsal cartilage

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Your question would be best answered after a thorough physical exam.  The fulness in your supratip (area just above the nasal tip) is either excessive scar tissue or under-resected cartilage that makes up the bridge of the nose.  Excessive scar tissue is best treated with a series of steroid injection, and, less commonly, surgical excision.  An under-resected cartilage is best treated surgically, to bring it into a more harmonious relationship with the rest of the nasal bridge.  Check in with your rhinoplasty surgeon or a general or facial plastic surgeon who performs lots of rhinoplasty.  An exam is important in determining the cause of your nose findings, and key to developing a good treatment plan.  Good luck!

Inessa Fishman, MD
Atlanta Facial 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.