Will a tip plasty only surgery create permanent improvement to the appearance of my nose? (photos)

Question

Hello I have consulted with a few diff doctors reguarding “tip plasty” I have had 1 failed nose job in past. Recently I have fat grafted to the bridge of my nose to cover inverted v deformity. I had 2 sessions most recent session was 2 weeks ago. Its not great but what bothers me most is the tip. I sadly cannot afford a full revision which is upwards of 18k. Can I have “Tip only” surgery to improve the tip with permanent improvement? Other doctors said no that results would not last

Thomas A. Mustoe, MD, FACS · Answer

It is true that fat grafting can disguise an inverted V deformity if it is mild, and that is much easier than full revision rhinoplasty.  A tip rhinoplasty can improve the tip, but you may still have issues in that in an ideal aesthetic nose, the tip is integrated with the upper nose.  In your case, an in person examination with careful discussion of what is possible with a tip rhinoplasty might be sufficient, but I would be very concerned that you would still not get the results you want.   However, a tip rhinoplasty does give permanent results, and in selected patients can be a good procedure.  They can be done as an office procedure under local anesthesia and light oral sedation which is of course simpler, and less expensive.

Suleyman Tas, MD, FEBOPRAS · Answer

Hi,
Based on your photos only tip plasty will not give you the result you expected,
to have pernament result, a Revision Rhinoplasty will help you to fix.
Kindly Regards,

Steven J. Pearlman, MD, FACS · Answer

Revision rhinoplasty is more challenging than primary surgery. However, in skilled hands, the results should be reasonably predictable. Fat injections are less predictable and since you recently had fat placed, it is impossible to tell if a tip plasty is all you will need. A personal exam by a revision rhinoplasty expert is a better way to tell. If you still have residual fat in your nose, try to bring photos from before the fat was injected

Ritchie Younger, MD · Answer

Thank you for submitting your photos-they are a huge help to understanding your concerns.  Based on these photos I might reluctantly suggest to you, that in my humble opinion-you may want to revisit not only your nasal tip-but also the positioning of your nasal bones.  Either return to the original surgeon who operated on your nose-pointing out that your bony  osteotomy work, for lord knows whatever reason-unfortunately has healed in an unusual fashion, and as such one solution may be to revisit this bony work to equalize your nose and minimize the v deformity that you are now enjoying.  To give yourself a symmetrically balanced nose, you may also want to have some volume reduction of your nasal tip, which may require grafting of cartilage to reinforce your tip, and if performed by an experienced surgeon with vast experience in revision rhinoplasty surgery-should last you for decades to come.  If your initial surgeon is not a Board Certified Facial Plastic Surgeon with vast experience managing noses-you may want to seek one out, who should readily be able to help you on your  road to a balanced, aesthetically pleasing nose, that not only allows you to mingle with confidence-but also allows you to breath without restrictions.  Power to you and your nose!!!!.

William Portuese, MD · Answer

Performing only a tip-plasty we will created imbalance with the rest of the features of the nose.  A full revision rhinoplasty as required to ensure all the components of the nose are balanced with themselves, and the entire new nose is balanced with patient's facial features.  Revision rhinoplasty is more difficult than a primary rhinoplasty, therefore an in-person examination is going to be required to make a determination on how best to proceed.

Richard W. Fleming, MD (retired) · Answer

A Revision tip pasty can be done and I disagree with the idea that the improvement "would not last". Having said that I recommend that you also revise the bridge so you achieve balance and a proportional result. Discuss this with your surgeon or a revision specialist,

Will a tip plasty only surgery create permanent improvement to the appearance of my nose? (photos)

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