How can I get a cuter shaped nose tip? (Photo)

Question

Hello, I had a consult and CT scan showing I had a deviated septum. My surgeon had said if I cosmetically wanted to fix the tip of my nose, which has a deep cartilage split at the tip, giving the appearance of a "butt nose"...that it would be a couple of stitches when closing up. But I believe my nose turns up and the skin between the nostrils hangs, due to what I believe was terrible allergies and constant nose itching. What would be the best way to get a cuter shaped nose tip?

A. Joshua Zimm, MD · Answer

It's difficult to really tell based on that one oblique view that you submitted, but it appears that your nasal tip may be over-projected (sticks out too far from your face as compared to your nasal bridge), and you may have a hanging columella (skin and soft tissue between the nostrils). Those would need to be addressed as well as any other findings that would be apparent on the other 5 photographic views that are required to do a complete analysis.   Each technical maneuver in rhinoplasty has ramifications, and it's a very complex operation.  It's rarely as simple as "placing a couple stitches."  If you are truly interested in getting some cosmetic work done at the same time as functional work, make sure you see a surgeon who specializes in facial aesthetic surgery and even more specifically, rhinoplasty.  Best of luck.

Kenneth Hughes, MD · Answer

I think that your goals are achievable with regard to tip refinement.Find a plastic surgeon with ELITE credentials who performs hundreds  
of rhinoplasties and rhinoplasty revisions each year.  Then look at the 
 plastic surgeon's website before and after photo galleries to get a   
sense of who can deliver the results. 	Kenneth Hughes, MD Los Angeles, CA

Edward Buckingham, MD · Answer

Clearly I cannot give
you specific advice about your specific nose without seeing you in person and
performing a physical exam.  In general  however, a bifid tip can be
improved by placing sutures in the cartilage and narrowing the angle and
distance of the cartilage.  For a hanging tip, the cartilage can also be
shaped by placing sutures and "tucking" the cartilage up.  These
sort of cosmetic changes can be accomplished at the same time as correcting a
deviated septum.  Rhinoplasty is one of the most rewarding surgeries to
perform, but also the most challenging.  Be sure to seek out a surgeon who
performs cosmetic and functional nasal work on a regular basis with quality
consistent results.

Toby Mayer, MD · Answer

your nose can be straightened inside and out as well as repairing your nasal cleft. Choose a very experienced rhinoplasty surgeon for the best results.

Steven M. Denenberg, MD · Answer

Hi, BriC,"A couple of stitches when closing up" pegs your doctor as someone who knows nothing about rhinoplasty. You must not let him operate on your nose.Changing your "butt nose" requires complicated work on the tip of your nose, using advanced techniques that not all plastic surgeons understand.

William Portuese, MD · Answer

A septoplasty and a rhinoplasty are two completely separate operations that can be both performed at the same time  under one anesthetic. To reduce the bulbous tip, suture techniques of the lower lateral cartilages are performed, or a moralized cartilage graft can be sewn in to prevent the "butt nose". Other surgical maneuvers during the rhinoplasty procedure can help prevent the turned up nose and columellar show. Allergies will need to be treated with medications which include antihistamines nasal sprays decongestants. For many examples of rhinoplasty in our practice, please see our rhinoplasty photo gallery link below

Richard W. Fleming, MD (retired) · Answer

Your nose can be straightened, the cleft between your tip cartilages eliminated, the tip repositioned, and the hanging columella (the tissue between your nostrils) lifted as part of the same procedure. As I always recommend select an experienced rhinoplasty specialist.

Robert E. Zaworski, MD (retired) · Answer

First of all, just because you have a deviated septum is not a reason to have an operation unless, #1 you have breathing problems, or #2 the deviated septum affects the external appearance of your nose. A "butt" appearance to the nose tip is due to cartilage deformities and will require an open rhinoplasty with reshaping of the nasal cartilages. This is one of the most difficult surgeries in Plastic Surgery so seek out a surgeon with some experience in these techniques. Be cautious.

How can I get a cuter shaped nose tip? (Photo)

Answers (8)

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