Nasal Tip Refinement

Procedures of nasal tip improvement are the most challenging in facial cosmetic facial surgery in general and in nasal reshaping in particular. No nose mirrors exactly the next; a fact that is in particular true for nasal tip constellations. Up to 95% of nose tip re-sculpting is achieved by changing the underlying nasal tip cartilages, mainly the lower lateral cartilages. Only about 5% or less of the change is achieved by work on the skin and other tissues. Interestingly, different techniques applied to the cartilages can yield good results. Nasal plastic surgeons today understand that it is a strong configuration of the tip cartilages that will give the nose a lasting shape. In contrast to rhinoplasty performed 20 years ago or so, only small amounts of cartilage are removed in modern rhinoplasty. Rather, the tip cartilages are reconfigured with the help of sutures or other techniques. Frequently, additional support is introduced through cartilage grafts.

Wide or Amorphous Nasal Tip

The bulbous tip usually has widely splayed nasal cartilages leading to a lack of attractive definition. Convincing the cartilages to take on the desired shape with strategically placed surgical sutures can lead to lasting reformation of these cartilages. When the strips of tip cartilages are rather wide, a thin portion can be removed safely for added definition as long as sufficient amounts of cartilage are left in place. At the end of the day it is important what is left in behind in the nose, not what is removed. How much is necessary is determined by the experienced plastic surgeon through careful examination before surgery and assessment during the rhinoplasty procedure.

Skin Thickness and Tip of Nose

The skin plays an important role in determining the appearance of the nasal tip. Commonly, thick skin has underlying weak cartilages and thin skin is associated with strong tip cartilages. For instance, African-American noses normally have thick skin and week cartilages contributing to the wide tip configuration with limited definition. Only small changes to the overlying skin envelope are possible therefore limiting the tip definition achievable. Strong structure has to be introduced in order to overcome the camouflaging forces of thick skin. Thin skin on the other hand will allow every little cartilage detail to show through, a fact respected by the rhinoplasty surgeon. In response, some nose surgeons will create a buffer layer between cartilage and thin skin in order to soften the cartilage edges. This layer may represent a sheath of soft tissue (i.e. fascia) and may be useful in certain cases. A rhinoplasty surgeon’s favorite constellation is strong cartilages and skin of intermediate thickness.

For more information, please click here to contact us.

As Seen In

  • prweb
  • wb56
  • worchester-living
  • cosmetic-surgery-time
  • nbs-30-connecticut
  • healthy-aging
  • 7news-boston
Are you ready to book your consultation?
Call 888-575-6673