Can I Get a Tip Plasty After Previous Rhinos?

This has been quite a journey for me. I have had 4 rhinos first was a botch. Apparently I don't have scar tissue. I have uneven cartilages and bossae in my tip. I have only had my tip touched once, the first procedure (open). surgeon left me with 5mm. My tip has no grafts. The revision procedures done by a different surgeon (closed) only touched the dorsal part of my nose to make it straight. My skin is good. Can I still get a tip plasty or is it too risky even though my tip has only been touched once?

Doctor Answers 11

Is It Possible To Have A Fifth Rhinoplasty To Improve The Tip Of My Nose?

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Dear Kailua Girl, I am so sorry you went through these multiple procedures on your nose.  Obviously, if the first surgery was not botched, things would have gone so much better for you.  I have read through some of your other posts, and it would appear that you live in the Bay area. 

The good news is you have one of the best rhinoplasty surgeons in the world in Oakland.  I highly recommend you get a consultation with Dr. Ron Gruber. 

All that being said, in my practice, I would do a closed tip plasty with cartilage graft from your ear to the tip of your nose.  Your nostril asymmetry can be improved, but perfection at this point is very, very unlikely.  Rhinoplasties are the quintessence of plastic surgery, and one should only go to Board Certified plastic surgeons with years of experience in rhinoplasties. 


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One year out and you may proceed with an open Rhinoplasty that will address the finer details of your nasal tip.  Please look to an experienced Cosmetic Rhinoplastic Surgeon.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Can I Get a Tip Plasty After Previous Rhinos?

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 I have performed Rhinoplasty and Revision Rhinoplasty for 25 years.  Yes, as long as the skin of your tip is warm to the touch, there should be ample blood supply for an open revision Tip plasty without a full Rhinoplasty.  If the tip cartlages were over-resected, this would most likely require a conchal cartilage ear graft to create shape and support in the nasal tip.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

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Tip plasty after multiple rhinoplasty surgeries

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In general, the more rhinoplasties you have performed, the more difficult each successive surgery will be. This is due to the following:

1) Shrink wrappage of the skin
2) Three-dimensional healing
3) Scar tissue

A revision is not out of the question. If you were to follow through with another surgery, I would recommend speaking with a qualified specialist. If necessary, 5-Flourouracil mixed with kenalog is a powerful way to help soften and potentially reduce the amount of scar tissue present after a revision rhinoplasty.  I have also seen some patients that are diagnosed with scar tissue who actually have think sebaceous skin.  In these cases, a light dose of Accutane, a medication that reduces the thickness of sebaceous skin, may help define your nose. Thanks and I hope this helps!

Tip Plasty After Previous Rhinoplasty Procedures

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Hello. You can have a tip plasty provided that you have enough cartilage for grafting. If cartilage was taken for your previous rhinoplasty procedures you cannot afford to have more taken, but this decision would have to be made by your board certified plastic surgeon. Best of luck!

Jaime Perez, MD
Rhinoplasty Specialist
Plastic Surgery Center of Tampa

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 81 reviews

Is It Worth The Risk To Have Another Rhinoplasty? It Depends

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A tip-plasty sounds like a possibility but I would recommend several consultations with experienced rhinoplasty surgeons before you make a decision. Every revision is more difficult than the one before it for a variety of reasons (scar tissue, loss of normal structures, blood supply to the skin, etc.). It may be that your expectations are achievable, but it is also possible that the risks of another revision outweigh the potential benefits. We spend a great deal of time with our revision rhinoplasty consults making sure that the patient truly understands the possible outcomes and risks. It is not something to be taken lightly. Get at least a couple of opinions before you make a decision. Good luck.

Michael R. Menachof, MD
Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 28 reviews

Multple rhinoplasty procedures

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I think the first question should be" will any result make you happy?"  Ask your friends if they notice any major problem with your nose.  Not having any further surgical procedure may be your best option.  A picture would help. Be careful.

Talmage Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon

Can I Get a Tip Plasty After Previous Rhinoplasty?

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Dear kailuagirl,

Revision rhinoplasty including tip plasty is certainly possible.

I would visit with a Board Certified Plastic Surgeon or Facial Plastic Surgeon who has significant experience performing revision rhinoplasty. It would be helpful for you to obtain copies of your previous medical records.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon

Revision rhinoplasty

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Dear Kailuagirl,

-Almost anything is possible, it just depends on what the tip looks like

-We would also look at your available cartilage and skin thickness

-Computer morphing will help give you an idea of what is possible

Best regards

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Tip Plasty after Previous Rhinoplasties

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From your description it sounds like a tip plasty could be done despite previous nasal surgery. When evaluating a patient for revision surgery I always consider the number of previous operations but equally important is what was done with each procedure. An experienced revision specialist can make recommendations after reviewing the operative reports and examining your nose.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 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.