Q: Dr. Eppley, I am interested in getting a rhinoplasty to reshape the tip of my nose. I have attached two pictures one picture being how my nose looks now (bulbous tip, very bulky in appearance) and a second picture of how I want it to be like. ( slim and straight) Would the result I hope to achieve be possible? What would need to be done to produce the desired result in the picture?
A: What you initially have is a bulbous tip that makes it fuller and stick above the rest of your otherwise straight dorsal line. This bulbous tip is composed of the union of the paired lower alar cartilages which are both wide (cephalic to caudal direction) and long. (anteroposterior direction) A tip rhinoplasty can reshape these cartilages by a cephalic trim, cartilage length reduction by medial footplate resection and dome narrowing by suture plication. Together these nasal tip changes are very likely to achieve the desired result that you have illustrated.
A tip rhinoplasty, what I call a Type 1 rhinoplasty, is done through an open approach and is associated with a fairly quick recovery. Some prolonged nasal tip swelling can be expected.
Dr. Barry Eppley