Can I address the tip only after a rhinoplasty? (photo)

Question

I’m over a year out from Rhinoplasty. Overall, I am happy with the results but not thrilled with the tip. The tip is still quite bulbous and it healed a few millimeters off center, this seems most obvious in photos and my nose looks crooked (wasn’t before.) I feel that the cartilage in the tip healed larger so you can now see it dropping above my upper lip. It’s subtle, but it makes my rhinoplasty feel unfinished and not perfect. Is it possible to address these tip issues without full revision?

Scott Trimas, MD · Answer

The bottom line answer to your question is that you can undergo a limited rhinoplasty that only addresses the tip region of your nose. It does appear you have some fullness in the area above the tip that might need to be addressed as well. I would recommend you discuss with your previous surgeon or seek an expert in facial plastic and reconstructive surgery who does revision rhinoplasty procedures. Good luck in your area.

Tanveer Janjua, MD · Answer

Yes, a tip-plasty will certainly help reduce the bulbosity. It can be done as an isolated procedure. 
Tip-plasty
Tip-plasty is a great procedure to address a bulbous tip only and leave the rest of the nose alone. It can be accomplished through an open or closed approach. The goal is to refine the tip and make it smaller and smoother. 
In tips with strong cartilages but thin skin, all that is needed is removing some of the cartilage and softening the rest by gently crushing it (morselizing). 
In tips with thick skin and lot of soft tissue or fat, the excess fat and soft tissue is removed along with removing some of the cartilage.
Click on the video link below.
Regards
Dr. J

Sang Hoon Park, PhD, MD · Answer

Hello, If you feel your nose tip is large and droopy, revision tip-plasty can help you. However, I would like to point out 2 things (limitation). You have metioned that your tip is off center but there is a chance it is positioned correctly considering the center of the philtrum and upper lip. Some patients have structural issue concerning the 'center'. Simply speaking, the center of the glabella (starting point of the nose) and the center of the philtrum (nose tip & columella) are not aligned. In this case, a person cannot have straight nose anatomically. Also, the deviation is more exaggerated when the nose is higher than when it is flat so some patients think the deviation is something new that suddenly happened after the surgery. The other limitation is about skin thickness, if your nose tip skin is too thick and it is stopping you from having dramatic result of tip-plasty, revision tip-plasty will not be as dramatic as you expect. Since I was not able to check your pre-surgery nose and current nose in various angles so please just consider this opinion as a reference. For more accurate plans, you should have in-person consultation with a surgeon.

William Portuese, MD · Answer

Revision rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery. A full set of facial photographs from all angles are going to be required, since the nose is a three-dimensional structure. A full revision rhinoplasty is going to be required. This can be accomplished with a closed rhinoplasty approach with all incisions placed on the inside of the nose. Also important to determine thickness thickness of skin in the tip of your nose which will affect the results. If you have thick skin in the tip of the nose, you only see very minimal benefits. The pinched areas in the midportion of the nose are going to be requiring spreader grafts placed in that location, which will also help straighten the nose. The hanging columella is addressed to the columella-plasty. In addition, I would be helpful to have a copy of the operative report for your next surgeon to understand what was accomplished in the first procedure and very important to know how much cartilage is  leftover on the inside of the nose for grafting purposes.

Can I address the tip only after a rhinoplasty? (photo)

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Answer: Can I address only the tip after my rhinoplasty

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Can I address the tip only after a rhinoplasty? (photo)

Answers (4)

Answer: Can I address only the tip after my rhinoplasty

Answer: Can I address only the tip after my rhinoplasty

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Everything you need to know about Revision Rhinoplasty

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