Why is There a Limit to How Much the Nasal Tip Can Be Reduced?

This a great question.

The key to understanding the concept of shape change in the nose is to appreciate that the tip is not just a lump of cartilage which can be carved into a different shape.

The nasal cartilages - and the nasal bones - are a thin shell, with complex and variable shapes.  They connect with each other and the shape of each affects that of the others. There are muscles attached to each, which open and close the nose up when you breathe.  The "design"of the nose is not about shape - it's evolved to produce adequate amounts of cleaned and humidified air to your lungs at all levels of activity and in all climates.

On top of the cartilage is skin of variable thickness. On the inside of the cartilage is the skin lining the nose, called the mucosa.  This is reactive to allergens and temperature and humidity.

When undertaking a rhinoplasty, planning involves shape changes which are possible, which are what the patient wants, and which don't reduce the airway functions of the nose - or indeed they might improve it.

The overlying skin has to conform to the new shape also.

So it's tricky and requires a great deal of experience to achieve consistent surgical outcomes in rhinoplasty. And there are limits to what can be done.

I hope this is what you were looking to understand.

All the best.

Part of the answer has to do with the overlying skin. In patients with thicker than average skin, you can reduce the cartilage down in size but the skin will not shrink wrap as much. Therefore, you will lose some shape and definition in this process. In other cases, the cartilage framework of the nose is too delicate to reduce its size any significant amount. To a certain degree, you have to maintain sufficient structural support for function of the nose.

     The lower lateral cartilages are composed of different segments, but they need to be continuity and have enough strength to keep the external nasal valves open.  Also, many people do not like a pinched look, which can happen as well.  Kenneth Hughes, MD Los Angeles, CA