How common is a nasal tip lift without grafts?

Grafting, or the use of cartilage for the nose, can encompass a wide variety of techniques.. there can be cartilage used in the structure of the nasal tip or more superficially under the skin.. I would suggest reviewing options with your rhinoplasty surgeon regarding their operative plan..

Unfortunately, it is difficult for me to provide feedback for you without seeing at least a few photos. I can tell you that tip refinement is handled using a variety of techniques, depending on the patient’s need, the amount of correction required and the desired outcome. Choose an experienced, board-certified plastic surgeon for your rhinoplasty, since this is the most complex of all plastic surgery procedures. With the right amount of expertise and artistry, your surgeon can achieve a very satisfying result no matter what technique is used. 

Hello and thank you for your question. There are a variety of techniques that can achieve the same objective in rhinoplasty. Each technique has its own advantages, limitations, and consequences (desired and undesired). Choice of technique is based on patient's anatomy, goals, etc. My best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon with extensive experience in performing rhinoplasty. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. In particular, pay attention to your surgeon's experience with rhinoplasty. Best,
Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

Hello and thank you for your question.  Nasal tip elevation usually involves a combination of cartilage modification, which includes trimming and suturing, and careful placement of cartilage grafts for tip enhancement and tip reinforcement.  Without any photographs to provide any further helpful advice, I would suggest you schedule a consultation to be evaluated in person with board-certified aesthetic plastic surgeon.  In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.  I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to the link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS

Harvard-trained Board Certified Aesthetic Plastic Surgeon

I’m not sure what lifting the tip means to you specifically. A tip graft is not always necessary. I’ve done over 500 noses without a tip graft. I can’t remember the last time I used one. I have taken out more grafts than I’ve put in because people hated them.  Sometimes a technique becomes popular and is overused. I would put tip grafts in that category.

Hello and thank you for your question.  In my patients, I always place a columellar strut graft for added tip support when elevating the nasal tip.  Strong cartilage support is needed in order to prevent recurrence of drooping.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Thank you for your question. Rhinoplasty is an art form that really depends on YOUR anatomy. Whether or not to use a tip graft is usually an intra-operative decision. After manipulating your underlying nasal skeleton, some people/noses require more structure or projection to get a desired result. Pick your artist/surgeon and let them do what they do. Review multiple galleries and go on a few consultations. Best wishes to you.

You are referring to tip rotation in which the tip is lifted and the nasolabial angle is opened. In a primary rhinoplasty top rotation is not achieved by cartilage grafting. Cartilage removal through cadual septal trimming, cephalic trim of the lower alar cartilages and sutre techniques achieves more than adequate tip rotation in most patients. While columellar strut grating is done in many primary rhinoplasties, its purpose is to support tip position and is not the primary cause of tip rotation.

The tip is probably the most challenging part of rhinoplasty.  I almost always use a double columellar strut formed by two strips of septal or auricular cartilage that are connected together - this gives a straight laminate of cartilage and also prevents tip pinching - and is sutured between the two domes of the nasal tip (double dome tip / double columellar strut).  This gives good projection and avoids pinching.  

Hi and welcome to our forum!Every nose has its uniqueness. There is no one cut and dry method to lift the nasal tip. It depends upon the physical findings of an examination. We do not have the benefit of photographs. Although frequently employed, cartilage grafting is not always required. Grafts are used to correct asymmetries or to add projection.Visit a board certified plastic surgeon for in-person evaluation and discussion.Best wishes...