Q: Dr. Eppley, I am in need of a tip rhinoplasty repair. The tip of my nose went bright pink about two years ago. I have consulted with dermatologists and ear nose and throat surgeons. Until today nobody could name what is to me a problem. I came across your website and I feel so relieved as I saw a picture of someone with my same problem. The tip of the nose has split. The cartilage is in two pieces and what used to be a nice nose, to me now looks wonky. I would like to come and see you and get it fixed. I look forward very much to hearing from you.
A: Thank you for your inquiry and providing your history and picture. Your history is a bit unusual for the classic bifid nasal tip deformity as the separation of the lower alar cartilages is almost always of congenital origin. The typical bifid nasal tip patient has had it all their life because that is just the way their nose developed. To develop a nasal tip crease later in life and after the tip of the nose developed a bright pinkness suggests not a tip cartilage issue but a crease that has developed in the skin itself. (perhaps from an automimmune disorder) Regardless of the specific cause (split of cartilage or dermal skin crease), it can be successfully treated by a limited open tip rhinoplasty. It may involve tip cartilage reapproximation, overlay septal cartilage grafting or a crushed cartilage graft. That would have to be determined intraoperatively when viewing what is on the inside.
DR. Barry Eppley