What Expectations to Correct a Bulbous Tip? (photo)

Hello, I am researching rhinoplasty to educate myself for future consultations (and detect any red flags in doctors). The whole procedure is terrifying, and I'm afraid of ending up with a madman wielding a knife. :P I have a bulbous, slightly drooping tip. What is the process of softening feminizing it? What realistic expectations can I anticipate? What are the common mistakes from hack doctors when correcting a bulbous tip? Thank you, have a good one!

Doctor Answers 12

What Expectations to Correct a Bulbous Tip?

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Please read all the expert response a few times! Than you NEED to see IN PERSON a few boarded surgeons in Texas. Find someone who listens and explains the operation/results to you. Than ask to see a few patients face to face. 

Bulbous tip

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If those are photos of you I think that you should get a great result. Most of what you have is very straight forward to correct. In an open rhinoplasty the skin is lifted up so that the bulbous cartilages can be reshaped while looking directly at it. This reduces the guessing and usually leads to a more predictable result. Start by getting some consultations where your nose can be better examined and better advised. good luck.

Realistic Expectations for Rhinoplasty and How to Choose Your Surgeon

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Hi Free Lilith,    You appear to have a very nice nose to begin with. Your expectations should be high as your nose should look more feminine, refined, and elegant.  It should respond very well to a properly performed rhinoplasty.   I would likely perform a closed approach conservative, subtle rhinoplasty which would remove a small amount of lower lateral cartilage, defat your tip, use sutures to refine the shape of those cartilages, and rasp and trim down a very small amount of your dorsal profile.  By removing a little of the lower lateral cartilages, the tip of your nose should rotate upward just enough.  See many rhinoplasty surgeons, look at their before and after photos of patients, look at patients in the waiting room, ask to speak with patients who have had surgery there, look at the staff if they have had surgery by the doctor.  Ask each consult if they were going to have another surgeon operate on their nose, who would they go to.  The most common mistake that patients make is being operated upon by a surgeon who lacks artistic vision, not taking enough time and effort to carefully choose their rhinoplasty surgeon.  The most common surgical mistake is taking too much cartilage from the nose and not leaving a strong underlying structural support for the nose.  Hopefully, by taking your time  you will not be under the knife of a "madman hacking away"!  Good luck and be well.   (see web reference and Youtube video below for more information).                Michael Persky, MD   Encino, CA

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

What Expectations to Correct a Bulbous Tip?

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Dear Lilith,

Thank you for your question and photos.  I answered your other question without the benefit of the photos.  Your bulbous tip is from having large 'alar' or tip cartilage.  These can be reduced and shaped.  Over reduction and having a 'pinched' looking nose are common errors in this type of surgery, as well as reducing the cartilage support structure so that the nostrils collapse while breathing in.   The following is a link with a lady who had her tip formed as discussed above, although i did not give her the curvy tip that I did on  the other patient.  

Best wishes, 

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Expectations to correct a bulbous tip

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I understand your concern but actually you are going about this the wrong way. "Hack" doctors are usually doctors who try to operate outside their field of training because the cosmetic industry provides an escape from low reimbursed insurance surgery. Therefore many doctors who are otherwise intelligent and good at their "other" field attempt to become plastic surgeons because the they can do this in the privacy of their office without interference by the state board whereas they would otherwise not receive hospital privileges as a plastic surgeon. The result has been a plethora of specialties claiming a portion of the plastic surgery pie over the past 10 to 15 years and it is getting worse. You will even see some of these groups claiming to be
"specialists" over and above plastic surgeons simply because they did a one year fellowship in cosmetic surgery. That is like a little leaguer saying he is a batting specialist because he went to batting camp for a few weeks yet he never played ball at the higher levels - the fundamentals were left out. My advice to you is to use the internet only for basic information, otherwise it will confuse and scare you. There is no way you can become educated enough on rhinoplasty that the information you learn will help you to choose a good rhinoplasty surgeon. For you to be safe and choose a well qualified surgeon who understands the principles of rhinoplasty and who can carry out the procedure with skill I recommend you do the following.

1.Find a surgeon who is Board Certified by a Board recognized by the American Board of Medical Specialties. That will be either the American Board of Plastic Surgery , or the American Board of Facial Plastic Surgery.

2. Choose a surgeon who is dedicated to aesthetic surgery in that he practices mostly aesthetic surgery and at least half his practice is devoted to the face.

3. Choose a surgeon who has been in practice long enough to have a lot of experience.

4.Choose a surgeon who has credibility within his own field. Someone who speaks at meetings and teaches other surgeons.

5. Make your final decision based on his qualifications and not personality, or how nice his staff is , or anything else completely unrelated to how well he does in the operating room. Check out his results. That is all that matters. 

6. If you can get word of mouth in person that is worth something. Internet reviews are notoriously unreliable. Case in point- one of the world's most famous and acomplished rhinoplasty surgeons in Dallas has an entire website devoted to tarnishing his reputation due to a mad patient who is psycho.

If you choose these options above you will have a much higher chance of finding a surgeon you can be comfortable with and then you have to have faith and trust his skill and training.

I wish you all the best. 


Grady B. Core, MD
Birmingham Plastic Surgeon
4.6 out of 5 stars 13 reviews

Bulbous tip

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Bulbous tips are either from over - developed lower lateral cartilages or thick fatty skin. Your nose is bulbous from over-developed cartilages. The video below goes through step by step reduction of bulbous tips. If the procedure is not done right, you can either get no results or more bulbous tip or other complications related to rhinoplasty.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Rhinoplasty bulbous tip

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Thank you for the question. A bulbous tip is a common concern for rhinoplasty patients. There are several factors that determine what techniques to use. Anatomy and skin thickness are important issues. What should be used on any individual should be determined by an experienced board certified surgeon (plastic or ENT) in a live consultation. Ask for pictures of work. Good luck!

Good candidate for a rhinoplasty.

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The skin is thin in the tip cartilages are strong. You should expect to get a very good result from a rhinoplasty provided you choose a good surgeon.

Refining the nasal tip

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Thank you for the question and the photos.  A bulbous tip can be refined via a "closed" approach (incisions inside the nose) or through an open approach (the inside nose incisions are connected across the columella.  You will have to discuss with your prospective plastic surgeon the final goal including the shape and contour of your entire nose and its relation to your face.  Great before and after photos, a good patient rapport with you, and good reviews should reinforce your decision that the board certified plastic surgeon you chose is the right one for you.

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Expectations from a rhinoplasty

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The result that can likely be obtained from a rhinoplasty has more to do with the thickness of the overlying skin.  The thicker the skin the less likely some of the finer changes will be visualized externally.  During a consultation with a plastic surgeon you should expect to discuss

  1. Your individual anatomy
  2. Your expectations
  3. Limitations of the surgical procedure
  4. Basics of the your individual operative plan
  5. Risks and complications
  6. Computer generated imaging for educational purposes

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 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.