Can I have just a tip rhinoplasty?

Can I have just a tip rhinoplasty, submitted image.

My nose looks pretty good except the tip part (looks boxy and wide). I'm sure I would look much, much better if I had a surgery to narrow the tip of my nose without changing anything else. Does it require an open rhinoplasty?

Hello Brian1na, Refining a nose tip is one of the most important parts of a Rhinoplasty procedure.  It's usually performed in either an 'open' or 'closed' fashion but both require incisions in the nostrils.  The 'open' method uses an incision in the skin in between your nostrils that will disappear.  I prefer the open method in treating noses because you can easily see all of the structures and make sure that they are even before you are finished.  This is much more challenging in the closed method and can potentially lead to more assymetry.  Having only the tip procedure performed will usually reduce your recovery time if no bone work is required but you would need to be seen by a Plastic surgeon to determine that in more detail.  Hope this helps and feel free to give my office a call for a consultation if you would like! 

Take care

Nikesh K Patel MD

Yes, it is possible to have surgery focusing solely on the tip of the nose. Perhaps the main difference between tip rhinoplasty and a full rhinoplasty procedure is that the former does not involve controlled breaks of the nasal bones (osteotomies).

However, it is very important to understand that the entire facial appearance must be considered when approaching rhinoplasty, not just nasal tip or even the nose shape. The goal is to achieve a natural-looking outcome that is in harmony with the rest of the face and enhances other facial features. Rhinoplasty typically addresses several anatomic nasal components, including the bridge, tip, radix and other features.

Enhance the appearance of the tip is largely a matter of manipulating the lower lateral cartilages. These cartilages may be altered to:

  • Enhance or reduce the projection of the tip.
  • Change the tip’s rotation.
  • Alter the angle between the upper lip and the nasal tip.
  • Change the height or width of the tip.
  • These changes may be made using either the closed approach (internal incisions only) or open approach, which involves an incision in the columella (strip of skin between the nostrils) as well as internal incisions.

Make sure to choose a board certified plastic surgeon or facial plastic surgeon to perform your procedure. Ideally, your surgeon should be able to use computer imaging software to demonstrate how the final outcome of your procedure might look. This technology allows the surgeon to make subtle changes on-screen in order to understand the look you are aiming for.

Dr. Frederic Corbin has 1 Nose job before & after:

Nose job before image performed by Dr. Frederic CorbinNose job after image performed by Dr. Frederic Corbin

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There are several methods available to reduce a boxy or bulbous tip and improve its overall shape, including delicate cartilage removal, placement of spreader grafts or other cartilage grafts, and special methods of suturing.

However, it is very important that the tip and lower portion of the nose be in balance with other portions of the nose as well as other facial features. Most patients require a more comprehensive rhinoplasty procedure that addresses the entire nose.

Regardless of the approach or complexity of your procedure, it will be performed under general anesthesia most of the time, as the nasal tip is a very sensitive area. There are some exceptions to this, since in some cases it’s possible to achieve what a patient needs using local anesthesia only - but you’ll have to speak with your surgeon about this.  To be considered a good candidate you must have realistic expectations of the outcome and be willing to accept that there will be some recovery time. Also, swelling can last up to a year.

Many patients have the same request as you: nose reshaping to improve or refine the appearance of their nasal tip, without touching the rest of the nose. This is possible in some, but not all, cases. Both the endonasal approach (closed rhinoplasty) and the open approach are possible, but open rhinoplasty is more often the best option when working with tip cartilages and other features of the nose tip.

Whether tip rhinoplasty alone is the right rhinoplasty procedure for you can only be determined through a comprehensive examination. The surgeon will not be able to give you an accurate assessment of your situation without feeling your nasal tissue, listening to your goals, evaluating your medical history and speaking to you about the pros and cons of cosmetic surgery.

Your tip nose surgery should be customized to your specific needs. The best way to ensure that your procedure is tailored to your anatomy is to locate a board certified plastic surgeon or facial plastic surgeon who is a rhinoplasty specialist.

Board-certified otolaryngologists with training in facial plastic surgery are also well qualified to perform rhinoplasty and related surgical procedures such as septorhinoplasty and revision rhinoplasty. Make sure that you feel comfortable with the surgeon and that he or she seems trustworthy.

The cost of your surgery will depend on the complexity of the procedure, geographic location of the practice, the surgeon’s experience and whether the procedure is combined with other procedures such as brow lift, neck liposuction, or chin augmentation with a chin implant.

Alexander Ovchinsky has 10 Revision Rhinoplasty before & afters:

Revision Rhinoplasty before image performed by Dr. Alexander OvchinskyRevision Rhinoplasty after image performed by Dr. Alexander OvchinskyRevision Rhinoplasty before image performed by Dr. Alexander OvchinskyRevision Rhinoplasty after image performed by Dr. Alexander OvchinskyRevision Rhinoplasty before image performed by Dr. Alexander OvchinskyRevision Rhinoplasty after image performed by Dr. Alexander OvchinskyRhinoplasty (nose job) before image performed by Dr. Alexander OvchinskyRhinoplasty (nose job) after image performed by Dr. Alexander Ovchinsky

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Yes you can.  A tip rhinoplasty is a very common procedure.  Please make sure that you see a Board Certified Plastic Surgeon before you proceed with any surgical procedures.