I want to know if nose tip refinement is adequate for my nose (Photo)

I amhaupy with the bridge, but the end is too bulbous. Also I want an upper lip lift, should this be done afterwards?

Doctor Answers 7


Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. You may also benefit from a cephalic rotation of your tip to turn up your tip slightly and a conservative dorsal hump reduction.  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. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

New York Plastic Surgeon
5.0 out of 5 stars 124 reviews


A rhinoplasty that reduces your tip cartilages as well as your dorsal septum slightly would refine your tip.  Some cartilage tip grafts would also help.  Best wishes, Dr. T. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Rhinoplasty Tip Refinement Only? No

Thanks for your post. A well planned and performed rhinoplasty offers natural results with overall improvement in facial harmony. In my view, you would be unhappy with a tip rhinoplasty alone as related nasal features could also benefit from improved refinement and support. Consider a comprehensive consultation with a reputable Facial Plastic Surgery who specializes in rhinoplasty and discuss your goals for the best recommendations. Best Wishes. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Tip Refinement Rhinoplasty Takes Finesse

Rhinoplasty is the most challenging of any facial plastic surgery.The tip of the nose is highly structured and nuanced. In your case, you have the extra challenge of very heavy and coarse skin and cartilage at the tip of your nose, which requires additional expertise to revise naturally and beautifully. That said, your nose tip can be reshaped to be more harmonious with your face, while leaving the bridge as is. Any procedures on your lips can be done at the same time. I hope this helps.

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 66 reviews


Thank you for your question and photographs.

I would recommend scheduling a consultation with a board certified plastic surgeon who specializes in rhinoplasty so they can give you a nasal examination and an accurate opinion on how to correct the things you are unhappy with about your nose. It looks as though you do have a bulbous tip and would benefit from a tip rhinoplasty which includes trimming the lower lateral cartilages and placing precision sutures to refine the tip and make it look more pleasing and proportional to the rest of your face. Best of luck in your endeavors.

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 75 reviews


In order to properly evaluate your nose, you would need to be seen in person and look at your nose from all angles as well as perform an internal exam.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Rhinoplasty for the bulbous tip and thick skin

Thick and sebaceous skin  in the tip of the nose will be a significant impediment to seeing refinement in the tip. To make a decision about how thick the skin of the tip of the nose is requires an in-person examination. The bulbous tip cartilages can be reduced and refined with suture techniques and a conservative cartilage removal. For more information, diagrams  and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 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.