What kind of tip refinement could I have done?

Question

Hello! As the title says, I have a quite apparent difference in my nostrils. One side is much more round when smiling and at rest, and has a higher nostril line. The other nostril seems to be lower, and has a more pointed profile. My nose becomes very wide and droops when smiling. The septum is possibly crooked, and squared, whereas I want it to come to more of a point.

Suleyman Tas, MD, FEBOPRAS · Answer

Hello, Thank you for provided photos and information based on them you can benefit  refining tip which involves reshaping  tip cartilages, septal cartilage grafts may need to be used for improvement.Closed and Atraumatic technique Rhinoplasty can improve your nose for  desired, balanced and well proportioned nose providing maximal healing, minimal edema&swelling with no scar.Best Regards,

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  You appear to have a bulbous nasal tip and soft triangle/ alar asymmetry.  Based on your photographs, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. This can be designed to improve your nasal symmetry.  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.  
 
 Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Philip J. Miller, MD, FACS · Answer

I would recommend starting with a consultation with a board certified facial plastic surgeon that specializes in rhinoplasty surgery to discuss if rhinoplasty can address your concerns. 
I would recommend writing down the following questions before scheduling your consultation:
1. Are you unhappy with the tip of your nose? 
2. Do you feel that your nose is too wide? 
3. Do you want to make your nostrils smaller in appearance? 
4. Are you looking to decrease the general size of your nose?
I hope some of these questions will help you pinpoint what it is that you don't like about your nose.  Cost will vary due to various factors like anesthesia fees, facilities fees, etc. I wish you the best as you research your options when scheduling a rhinoplasty consultation.
Sincerely,
Philip J. Miller, MD, FACS Double Board Certified Facial Plastic Surgeon

Pejman Aflaki, MD · Answer

Hello and thank you for the question and sharing your photos. You do have a bulbous tip resulting from prominent alar cartilages. Additionally, septum seems to be deviated, giving the crooked appearance to your nose. You will benefit from a rhinoplasty procedure focusing on tip refinement and correction of deviated spetum. There are a variety of techniques that can be utilized to refine the nasal tip, including trimming the alar cartilages, suturing and cartilage grafting. Your surgeon typically uses a combination of these maneuvers depending on your particular anatomy. I would recommend you see a board-certified plastic surgeon for a complete evaluation and advice. Make sure your plastic surgeon has experience performing rhinoplasty. You should look at before and after photographs of real patients with real results. Best,Pejman Aflaki, M.D.Double board-certified plastic surgeon

Mehdi Sina, MD · Answer

Hi,First and most notably the asymmetry between the height of the nostrils is very difficult to correct surgically. If that is your primary goal, you are likely to be disappointed. A rhinoplasty CAN make your nose more straight and improve the definition of the nasal tip as well as adding strength and support to prevent the tip from drooping when you smile. Once the tip is straightened, the nostrils (shape) are likely to have improved symmetry. I recommend visiting with a rhinoplasty expert to have a detailed discussion of your aesthetic goals.Best,

Greg Bran, MD, PhD · Answer

Hi there and thank you for the photos. According to your pictures you have an asymmetric tip. This is partially caused by a deviated septum (the nasal wall in between your nostrils). This deviation pushes your nasal pyramid (the upper two thirds of your nose) to your right side (best to be seen in photo 5). your septum then bends toward the left side, which results in your tip leaning even more to the right side. In frontal view you will be able to appreciate two types of asymmetries: 1st (as already described) the height of your domes differ (your left dome is a bit higher ... due to the septal bend), the other asymmetric is in the area of your alar base (the transition of your alar into your cheeks). your left alar base is slightly higher then your right. This is congenital (due to your DNA). As your face was growing (and up until today) your facial muscles pulled stronger on your left alar base then on your right. This is the only detail that still cannot be corrected in a reliable fashion in every patient. All other asymmetries can be addressed during a primary septorhinoplasty. However, it would include more than just some tip work, as asymmetrical bones and a deviated nasal septum need to be addressed in order to achieve a satisfactory long-term result. 
Good luck and kind regards, 
GB

Richard W. Fleming, MD (retired) · Answer

Your wide asymmetrical tip can be improved by changing the contour of the underlying cartilages and the use of small cartilage grafts to improve symmetry of the nostril rims.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Based upon your photos, it appears your right nostril is lower than the left and the nasal tip is bulbous in nature.  Your nasal bridge also appears slightly crooked. Refining a bulbous tip involves reshaping the tip cartilages. Septal cartilage grafts may need to be used for tip support.  I would suggest a formal in person evaluation with a rhinoplasty specialist to learn of the your best treatment options for both the nasal bridge, nostril asymmetry and tip shape.  Make sure you see numerous before and after photos with results you like and seek. Request computer imaging.  This step ensures that you and your surgeon are united as to the desired end result.

What kind of tip refinement could I have done?

Answers (8)

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