Tongue n Groove technique - How do I know the doctor used this technique and how would my nose feel?

I had a revision rhinoplasty and I know last time I didn't have tongue n groove but I have a feeling the doctor might have done it this time around. How do I know that I have that procedure? I am only 2 months post op but my tip and the entire nose feels a lot different compared to the last surgery. It is much stiffer at the tip and collumela area and when I push on it lightly its hard unlike last time . It almost feels like I might be touching a septum when I touch the tip of my nose.

Doctor Answers 5

Tip stiffness

Tip stiffness is pretty common after rhinoplasty and more so with open techniques. If a tongue and groove approach was used your surgeon can tell you.


New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Probably the technique not tongue in groove

It is not uncommon to have a very firm tip after open rhinoplasty (incision between the nostrils), regardless of whether the tongue in groove technique was used or not.  This does eventually resolve but it often takes 6-12 months until the area softens.  If you had a "closed" rhinoplasty the first time and an "open" rhinoplasty for the revision, that would certainly explain the difference.  Even if you had an open rhinoplasty with both cases, you may have required more cartilage grafting in the tip with the revision which will make the area feel more firm.  Hope this helps. 

Garrett Griffin, MD
Minneapolis Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Tongue in Groove Technique / Rhinoplasty

The TIG technique consists of a method by which the mesial crura are advanced onto the caudal septum into a surgically created space between the paired cartilages. It provides a method for correcting excess columellar show and can also be used to control nasal tip position, rotation and projection. After the TIG technique has been performed, the columella will be firmly up against the nasal septum and will not move freely. However, scar tissue and cartilage grafts can also limit movement of the columella after surgery and it can be very difficult to distinguish between the two. The best solution is to simply ask your surgeon.

Brock Ridenour, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 99 reviews

Tongue in groove

The easiest way for you to find out if you had a Tongue and Groove technique is to ask the surgeon that performed your rhinoplasty. It is actually common to have stiffness throughout the nose in the months following a rhinoplasty. This will gradually become softer over time as the nose heals. Be patient throughout the process and make sure you have adequate follow up. Best of luck.

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

Firm tip following revision rhinoplasty

A firm and often times stiff nasal tip following rhinoplasty and revision rhinoplasty is nothing to be too concerned with.  Over time your tip will soften and feel more natural.  As far as the technique which was used, it would be difficult to say without an actual operative report.  A stiff tip can occur following the tongue and groove technique, but also with the placement of a columella strut for tip support, and even after tip sutures and tip grafts.  Sometimes in an effort to give you the best cosmetic outcome, the surgeon will use a lot of these maneuvers in order to prevent changes that can occur to the nose long term.  Steroid injections for significant swelling can be of help but nothing replaces patience and time. 

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.7 out of 5 stars 25 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.