Polly beak deformity: from thick skin, scar tissue, elevated bridge, drooping cartilage, or all? (Photo)

Dear Tinelillian in Santa Barbara, California:
It is hard to say whether or not the tip rounded and dropped a little bit because of lack of support or due to the fact that, in some people with thick skin, as the tip narrows spontaneously in the healing period the skin thickens up.  A very experienced surgeon should be able to tell the difference and it is possible that by injecting some cortisone or steroid that it can help solve the problem, because if the skin has become thicker that is the antidote to that problem in many cases.  The time to do it is now, because 14 months after surgery has been enough time for the skin to “ripen” and for the result to be visible.  Whether or not lowering your bridge will help is hard to say without feeling the bridge.

 Consult with a surgeon who has long experience, is highly specialized and focused on rhinoplasty,  and has a huge photo gallery so you can find results of patients who had problems similar to yours.  Be sure to bring a written list of questions.  Bring all of your photographs and operative reports from your prior surgeon.   Bring a friend or family member to also listen and observed.  his will make it a much more productive consultation.  Before you go, look at a lot of websites, read the reviews, read books, and learn as much as you can.  You want to do it right the second time and, hopefully, you maybe will have improvement without surgery.

     Best wishes,

Robert Kotler, MD, FACS

Over 4,500 nasal procedures performed

  A poly-beak deformity can be caused by all of the above reasons.  A thorough examination is required to make a determination about what the cause is.  When you have identified the cause,  then a plan for correction can occur.  A revision rhinoplasty is more difficult than a primary rhinoplasty due to scar tissue and thick skin present and alterations of the normal anatomy.  If the issue is excess thick skin, steroid shots  should be  beneficial.  If there is residual cartilage present  in the lower portion of the nasal dorsum, a touch up revision procedure can be performed.