What Kind Of Revision Surgery Could I Get To Round The Square Tip of My Nose?

Hello, it has been now 10 months since my septo/rhinoplasty, the surgeon took out a dorsal bump and made the tip smaller. Now that the swelling is almost gone, the tip looks very angular and maybe too narrow, there is a bump on one side of the tip, and the nose looks pinched on one side. The doctor likes to put fillers to solve these small problems but I have chemical sensitivity, so that is out of the question. What kind of surgical procedure I need to make the tip rounder? thank you

Doctor Answers 7

Revision rhinoplasty to round a square tip nose

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Making the tip more round can be done by a combination of grafts, such as alar rim grafts, alar baton grafts, and spreader grafts.  The important thing to know is whether or not there is enough cartilage inside the nose for grafting material.  

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

How to improve angular, pinched tip after prior rhinoplasty

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I can see what you mean when you note the more angular tip. This can likely be improved with a revision procedure, though your nose is tricky given how thin your skin is. This thin skin is what allow the edges of the cartilage of your tip show through and give the sharp appearance.

You may have had cartilage grafting placed in the tip to give it definition. Revision surgery could address this in addition to the notching that you can see to the sides of you tip itself. This isolates the tip and accentuates the pointiness. Rim grafts can help improve the transition from the tip to the ala. There are ways of thickening your tip using perichondrium (the thin tissue covering found on cartilage) or fascia (tissue that covers muscle).

Consulting with an expert revision rhinoplasty surgeon would be recommended for you to get a better idea of your options.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Angular Nasal Tip Following Rhinoplasty

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Looking at your photos provided, I would agree that your tip appears more angular and sharp than it should be. For your face, it would be more appropriate to have a more convex, slightly rounded nasal tip instead. This type of problem is encountered in some cases of rhinoplasty where the tip cartilage has been reshaped and the nasal skin shrink wraps down to reveal unwanted cartilage angles and corners. This is usually corrected with revision rhinoplasty surgery with use of cartilage grafts to reshape the tip. The goal would be to add cartilage to the tip so that a more convex contour is created - which translates into a more rounded looking tip. With the degree of skin shrinkage that you experienced, it may also be recommended that you have temporal fascia grafting over the cartilage to provide a thicker soft tissue covering. Make sure you consult with an experienced revision rhinoplasty expert who has specialization in managing this type of nose.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

Tip issues

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The prominence of your nasal cartilages may be the occurrence of the skin shrinking around your cartilages. Fillers can camouflage this a bit, but they will get absorbed. Sometimes revising the rhinoplasty by adjusting the cartilages or adding temporal fascia as a blanket( thickening layer may help.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Pinched tip

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You have experienced what is sometimes called the "shrink wrap" effect. As the skin swelling reduces the skin contracts around the narrowed cartilage and if it is not strong enough to resist this contracture there is pinching and angular points. Fillers willonly camouflage the problem. You need to have the tip resupported and sometimes the skin as well if yours is very thin.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Pointy square nasal tip

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Rhinoplasty in persons with thick cartilages and thin skin can ocasionally result in bossae. This occurs when the soft bend in the tip cartilages tighten and become more visible through the skin. Correction of this type of appearance generally requires open revision rhinoplasty with reconstruction of the tip cartilages and possibly temporal fascia grafting to help thicken the skin.

Behrooz Torkian, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 17 reviews

Rhinoplasty revision for a pointed tip

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If you feel your tip is a bit to pointed there is a solution.  The correction would likely involve an open rhinoplasty, allowing for complete exposure of the cartilages and greater control.  Rearrangement of the tip cartilages may be necessary, as well as possibly an on-lay graft.  Temporal fascia grafting way also be warranted if your nasal tip skin is very thin.

Leif Rogers, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 26 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.