What Could Be Done to Slim my Bulbous Nose? Tip? (photo)

Thanks in advance for any insight. I am a 45 year old women who is seeking a primary rhinoplasty to mostly reduce the tip of my nose. Due to my age, I really don't want a drastic nose job. Does it look like I would only need tip work? Also, am I too old? Thanks again!

Doctor Answers 14

Bulbous nose

You appear to be a great candidate. Your photo suggest that you have strong large convex tip cartilages which create a shape that is out of proportion with the rest of your nose. Since this is primarily cartilage and not thick skin you should be able to have nice reduction and shaping. How much change you would like is something for you to determine with your surgeon. It's too hard to say from these photos whether or not you would need other work on your nose. Your age will only make you appreciate the change more and should not be a deterrent. Good luck!

West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

How we reduce a bulbous nasal tip

To reduce a wide, round nasal tip we utilize a number of techniques. Nasal tip cartilages are reshaped by removing some cartilage to weaken them. Further narrowing and shaping is obtained by using carefully placed sutures in the tip cartilages. Third, we sometimes actually use grafts of your own cartilage to support the nasal side-walls so they don't collapse from this narrowing. Nothing beats a personal consultation with a rhinoplasty expert. I also find that computer imaging helps a lot in visualizing potential result.

As for age, there is no age limit to getting a nicer looking nose.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 125 reviews

Rhinoplasty for bolbous tip

It appears that besides your bolbous tip, your skin is thick.

I would reshape the tip with lateral crural strut grafts. These would both,decrease the boulbosity and give your tip support to prevent pinching.

Best of luck

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 112 reviews

Bulbous Tip

Yes, I think you would be a good candidate for a rhinoplasty.  A tip only surgery might suffice, hard to say without directly examining your nose.  It would appear from the photos that you have large, broad, stiff lower lateral cartilages that would need to be adjusted in both size and shape.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

Bulbous Nose in 45 Year Old Lady

First of all, your age will have no affect on the results of your rhinoplasty surgery. The tip can be reduced and the shape improved. Exactly how this will be done will be determined after physical examination to evaluate the strength of the tip cartilages and the size and position of the surrounding nasal structures that are not clearly seen in the pictures you sent. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

A Tip Rhinoplasty is Appropriate.

Shabby, you are an attractive lady and I agree that you would be best served by refining your nose tip.  At age 45, the tip is probably starting to sag a bit and stretch out and therefore appear wider.  It is not unusual to have just the lower half, or tip, of the nose operated without “breaking” the nasal bones or doing any other maneuvers.  Sometimes it is necessary to do very minor shaving, but the core of the operation involves narrowing the tip of the nose by removing some of the cartilage and sometimes even adding a bit by removing some of the cartilage that is better defined in the lower half of the nose. 

Check out our and other websites and you will see examples of patients with very similar issues and then see how the rhinoplasty corrected the abnormality. 

Robert Kotler, MD, FACS
Facial Plastic Surgeon


Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 86 reviews

Refining a Bulbous Tip

Yes, it appears that you have very robust lower cartilages.  These can be shaped along with your tip to give you a very natural but more refined nose.  An in-person consultation is mandatory to determine the best surgery for you.  Good luck!

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.7 out of 5 stars 45 reviews

Slimming a bulbous nose tip

Nasal tip surgery is one of the most difficult procedures to perform in the field of rhinoplasty.  Rhinoplasty is one of the most difficult procedures to perform in the entire field of cosmetic surgery.  It is important to make sure that the tip is done well so that it balances with the rest of the nose and facial features.  The nose should be narrowed in such a fashion, that it looks natural, un-operated upon, and yet still breathes well through the nose.  The bulbousness of the tip has to be brought back into alignment with the rest of the nose.  Additionally, in the majority of cases the entire nose will need to be adjusted to make sure that it all balances equally.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Slimming bulbous nose

From your photos it looks like you have very broad, convex lower lateral cartilages. I prefer addressing this my reorienting the cartilages in a more flat configuration. Usually this involves lower lateral crural strut grafting using septal cartilage. The beauty of this approach is that it maintains very natural external tip contours and avoid long term problems such as tip pinching and breathing difficulty.

Whether only your tip would need to be address depends on the the rest of your nasal exam. If that's the only area of concern certainly just the tip can be changed.

As long as your health is good, your age is not an issue and plenty of my patients have had this type of surgery in their 50s and 60s.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Bulbous Nasal Tip Reshaping at 45 Years Old

If you don't wish to have any drastic changes made to your nose, then tip rhinoplasty may be the only thing you want to have done. As far as your age is concerned, don't worry about it. I happen to do rhinoplasty surgery on women your age on a very consistent basis. I have attached a link below that provides more detailed information on management of the bulbous nasal tip. I hope this provides you some further insight. 

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 40 reviews

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.