Tip Nose Graft Adjustment or Removal? (photo)

I had a rhinoplasty cartilage graft done to disguise a dent in my tip 4 years ago. It has now made my nose longer and and has a very hard prominent point and I would like to shave this down or remove this entirely. Is this an easy procedure and would this cost very much? I liked my nose before apart from the big dent in the middle now I very much dislike my side profile. Thanks Lexi.

Doctor Answers 7

Unhappy with nose Tip Nose Graft

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It is hard ethically and professionally to comment on your present nose without seeing photos of your old nose. Revision nose surgery is sometimes similar to moving ore removing cards in a house of cards; everything may shift and in some cases even crash.

Your skin is thin which would make any tip adjustments easier than if you had thick skin.

Before embarking on another expensive and potentially irreversible procedure I would recommend you see SEVERAL Plastic surgeon experienced in revision nose surgery. A pattern of advice may be evident after they examine you and I would go with the one you trust the most. 


Peter A Aldea, MD
Memphis, TN

Memphis Plastic Surgeon

Revision for an overprojecting tip

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From your photos we can see an unbalance in the nose as the tip is overprojected and the columella is widened with a 'strut' graft to hold the tip out. Remove and adjust may sound simple, though secondary or revision rhinoplasty generally is not. The best time is the first time, however everything can be set straight. Choose your surgeon very carefully, and computer imaging will be a great guide.

Tip Nose Graft Adjustment or Removal?

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Very hard to advise over the internet even with the GREAT posted photos. Best is to seek ONLY IN PERSON evaluations. 

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Revision rhinoplasty surgery

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Dear Lexi30,

  • Yes this can be done with revision rhinoplasty surgery
  • If you just want to make the nose stick out less, it would not take too long
  • If you want other changes while you are asleep, then this would add time and cost to the procedure
  • It just depends on exactly what you want, and a consultation would be very beneficial for you

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Tip after Graft Placement

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Your over-projected, asymmetrical tip can be reduced and the hanging columella corrected. However these changes can be problematic if not done by an experienced revision rhinoplasty surgeon. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

How Can I Improve My Nasal Profile?

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Dear Lexi, The angle that your nose makes with your lip is between 100-105 degrees, which is just about perfect.  However, it is a straight line from your upper lip to the tip of your nose.  There should be what is referred to as a double break.  To create this double break, an upturn of the cartilage from just past your nostrils to the tip of your nose should be a separate elevation.  This technically is an easy fix.  It will automatically shorten your nose and it will assist you in getting a super tip depression, which will also add to the attractiveness of your nose.

The two maneuvers suggested above, known as a tip plasty or profile plasty, would be a relatively simple procedure for a Board Certified plastic surgeon experienced in rhinoplasties.  

Excess tip projection

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Shaving the tip cartilage or complete removal can correct this.  The tip domes can be sutured together to avoid showing the midline depression.  This can be done open or closed by delivering the tip.  

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.