Rhinoplasty, or nose surgery, is a common cosmetic plastic surgery procedure. Some of these surgeries are done to improve a function of the nose, such as breathing. Other purely cosmetic surgeries are for altering the shape of the nose and can have dramatic effects on facial shape and the relationships between different parts of the face. Cosmetic rhinoplasty can provide a more harmonious balance to the face.

The typical nose surgery involves surgery on the bone (the upper third of the nose) and the cartilage (lthe ower two thirds of the nose). A tip rhinoplasty is when your cosmetic plastic surgeon operates only on the cartilage to improve the shape of just the tip.

The nose tip can be made:

• thinner if rounded
• elevated if droopy
• straightened if curved
• narrowed if wide

The skin of the nose can be very thick in some patients and can hinder the cosmetic result.

The nose tip is made up of two inverted U-shaped cartilages called the lower lateral cartilages. Each lower lateral cartilage has two limbs. One limb comes together to form the columella of the nose—the thin part between the two nostrils. If these parts are too large or misshapen, the nose will have a droop. The other limb on the top of the nose is what causes the nose tip to become round or pudgy.

Most incisions for a tip rhinoplasty are made inside the nose and are not visible. The surgery is typically performed under local anesthesia in my office. Cartilage is re-shaped or removed and can even be placed on the top of the nose (dorsum) to make the bridge of the nose higher. The upper limb of the lower lateral cartilage is made thinner by removing excess cartilage. The tip can be elevated by removing part of the septum and cartilages. The columella can be elevated or made thinner also. The nostrils can be made smaller by removing skin at the base of the nose.

• wound separation
• cartilage warping
• infection – rare
• bleeding – rare

Recovery from tip rhinoplasty is relatively quick and painless. Since no bone work is performed, there is little bruising or swelling of the face.

No hard splint is used, but paper bandages are placed. The bandages remain for one week and thereafter can be removed and placed on the nose only at night to decrease swelling. Stitches are removed in one week; final healing, though, can take 8-12 months!