Tip-plasty with Hard Nose Tip After Rhinoplasty?

Question

10 months ago, I had Rhinoplasty to remove a bump on my bridge, the tip of my nose is still very hard. I was wondering if this is normal? And I was thinking of having a tip-plasty to make my tip less protruding, could a hard tip prevent a tip-plasty?

Oakley Smith, MD, FRCSC · Answer

Unless you had a tip graft placed. This is cartilage shaped to look like a nasal tip. Its a very powerful technique and is often used. Sure the tip will not be as soft as before surgery, but at 10 months there should be some give. Hence the explaination is the extra cartilage you now have. Plus it sounds like it is placed poorly, if you have too much protrusion. Check with your surgeon. Whether you should have further surgery by him/her is a complex matter. There just are too many factors to make that call. Good luck.

Philip S. Schoenfeld, MD, FACS · Answer

A firm nasal tip is not uncommon following rhinoplasty.  If after 10 months your tip has not softened a great deal it may be that a tip graft was placed and the soft tissue is around the graft is still maturing. The tip will usually soften over time following rhinoplasty.  Performing revision surgery on the nasal tip is not advised if the tip is still hard.  Be patient.  If the tip is deformed, revision rhinoplasty can be safely performed at one year.

Scott Trimas, MD · Answer

Tip firmness after rhinoplasty is very common and can even persist up to 18 months. Other causes can be the placement of a tip graft that is cartilage or some other material. In either case, it is best to wait at least a year after your original rhinoplasty before undergoing a revision procedure. I would discuss this with your original surgeon or have a consultation with a rhinoplasty surgeon experienced in revision procedures. I hope this information helps.

Toby Mayer, MD · Answer

As the other surgeons have said the tip of the nose can stay hard for a year. It will be hard beyond that point if a large tip graft was used or a strut that protrudes to the tip. You can still have a tip plasty. See an experienced revision rhinoplasty surgeon for the best results.

Steven J. Pearlman, MD, FACS · Answer

The amount of swelling and firm scar tissue depends on the thickness of your skin and the technique used to refine your nose. Sometimes grafts are used in the tip of the nose that may feel firm for a very long time. I would suggest waiting at least a year or more before considering revision of a firm tip. Firmness can mean that healing is not complete.

William Portuese, MD · Answer

A hard-feeling tip will not affect the tip plasty procedure. The hardness of the tip is probably related to the previous surgery. There may be sutures in the tip or cartilaginous strut grafts, all of which can cause a hard nasal tip. A revision tip plasty can certainly be performed. Look for a surgeon who has performed thousands of rhinoplasty procedures including tip procedures before embarking on a difficult revision rhinoplasty.

Nina S. Naidu, MD, FACS · Answer

You should expect swelling for at least a year following any rhinoplasty, and sometimes longer in patients with thicker skin. You may be a candidate for further surgery on your tip, but I would advise waiting for several more months and then discussing this with your surgeon. Good luck.

Peter E. Johnson, MD · Answer

After rhinoplasty the nose looks quite well after a week, however the healing process will go on for a year or longer. The tip is a mirror to the completeness of the healing. Firmness will remain the tip until the healing is complete, and often the tip will stay slightly fuller or broader until softness returns. Therefore, the complete results become apparent after a year, the best time to contemplate revisions or further changes if needed.Best of luck.

Richard W. Fleming, MD (retired) · Answer

Tip firmness after rhinoplasty usually indicates there is temporary residual swelling. This is not uncommon 10 months after surgery, especially if grafts were placed in your tip. It best to patiently wait for this swelling to resolve before considering a tip-plasty.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,
Typically a hard tip can be a result of an "open rhinoplasty". I assume you had a closed rhinoplasty to remove the hump on your nose. You can now have a tip-plasty to make the tip less protruding. If you had an open rhinoplasty,  waiing 6 months to a year is adequate time for a Tip-plasty.
Best,
Dr.S.

Tip-plasty with Hard Nose Tip After Rhinoplasty?

Answers (11)

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