Can a simple rhinoplasty be performed on only the nasal tip? (Photos)

Question

I'd like to keep the top 2/3 of my nose in tact, and only have some cartilage removed from the tip to reduce my bulbous and dropping nasal tip. is this possible? if so, will it be less expensive than a traditional rhinoplasty?

Anthony Corrado, DO · Answer

It is very common for patients to request tip modification as their only cosmetic request.  I routinely perform tip rhinoplasty as a solitary procedure for patients who are pleased with the rest of the features which make up the nose.  I would suggest an in person consultation to discuss your specific goals, and expectations for surgery.  Good Luck!

Randal Haworth, MD, FACS · Answer

Thanks for your question and photos. For refining the tip of the nose, either a closed or open (my preferred method to get maximum control of symmetry) tip rhinoplasty can be performed which refines the tip with minimal scarring.   An open technique allows better visualization and control of the paired cartilages which act in conjunction to define your tip shape and symmetry.  The ability to see both cartilages simultaneously and work on them together allows the surgeon ultimate control over both the shape and symmetry and, of course, beauty of the nose. It's best to set up a few consultations with different surgeons and make an informed decision based on their experience and speciality in the field. View their before and after photos to see what the outcome could potentially be.

Andrew Miller, MD · Answer

It is certainly possible to keep the upper 2/3 of the nose intact. The nasal tip can be refined so that it compliments and balances the rest of the nose. This tip rhinoplasty may be slightly less expensive than a full rhinoplasty, but not much, because the tip is the hardest part of the procedure. Also, a lot of the cost of rhinoplasty is just into getting the operating room, the set up and supplies, nursing, anesthesia, etc., which are pretty fixed costs. Just make some consultations with rhinoplasty specialists and you should get a good idea of what needs to be done and the costs associated.

Steven M. Denenberg, MD · Answer

Click on the "Learn more" link, just below my response, or go here:
FacialSurgery.com/RealSelf/RealSelf_michaela2212.html
I made a couple of computer morphs of your nose, and animations of the morph, to show the changes that are possible for your nose in truly expert hands.I elevated the tip. It's not terribly bulbous, but width of the tip can be addressed at the same time. You'll see, however, especially in the animations, that I narrowed the bridge a little, where it seems to be wide on your right side, making it look like a little bulge on the three-quarter views you submitted.
You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon. You should only have surgery if you are able to make yourself very confident in your surgeon's skills. Read that page very carefully. Most plastic surgeons are quite poor at this operation, and I believe my advice will go a long way toward keeping you safe.
I'd love to hear what you think of the morphs. Did they seem to address your main concerns?
Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who understands all of the issues I mentioned, and how they fit together, and who can actually accomplish them in surgery.

Philip S. Schoenfeld, MD, FACS · Answer

You have asked two questions.  You can certainly can leave the upper two thirds of your nose untouched and have some modifications of your nasal tip only.  I will caution you, however, that your surgeon may demonstrate that changes to your nasal tip shape, projection. and rotation can also change the relationship of your nasal tip to the upper 2/3 of your nose and you may want some minimal modifications performed.  In terms of cost, most surgeons would say that the nasal tip is the most difficult part of the rhinoplasty procedure and unless you required minimal intervention to the nose, the price will not likely vary to any significant degree.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty.  You may also benefit from a cephalic rotation
of your tip to turn up your tip slightly.  Cost varies based on  geographic region and surgeon expertise.  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. FACS
Harvard-trained plastic surgeon

Jonathan Kulbersh, MD · Answer

You may benefit from a tip refinement, which would shorten and reshape your tip. However, it may be that the most dramatic improvement would require some reshaping of the bridge; an in-person consultation will determine the best course. Your best bet is to start consulting with experts in your area. I hope this helps

Philip J. Miller, MD, FACS · Answer

One of the biggest limitations to a more defined tip is simply the skin. Unfortunately, we can make the inside of the nose as small as possible but the overlying skin needs to contract around the cartilage underneath. I would recommend starting with a consultation with a board certified facial plastic surgeon that specializes in rhinoplasty surgery. 
Sincerely,
Philip J. Miller, MD, FACS Double Board Certified Facial Plastic Surgeon

William Portuese, MD · Answer

First of all, rhinoplasty is not simple and  is important to understand that it is one of the most difficult procedures to perform correctly in the entire field cosmetic surgery. Performing only the tip plasty  will leave the remainder of the nose unbalanced, so its usually not a good idea. It is important that all of the components of the nose balance with themselves, an  the entire new nose balances with your facial features. For many examples of a full rhinoplasty, please see the link and the video below

Robert L. Kraft, MD, FACS · Answer

You need to think about the nose as a geometric structure. Other than small modifications to the tip, in order to perform a rhinoplasty, we must keep the pyramid intact. In your case, I do not think that a small amount of tip work would achieve an appropriate result.  The bridge must be addressed as well.

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