The tip of the nose is one of the most complex areas for rhinoplasty. Generally speaking, patients wish to refine the tip of the nose in a primary rhinoplasty and, when it is drooping, to bring it into a harmonious position.
Nose tip surgery can only be performed when the bone and ridge are in good condition. It should also be noted that the tip of the nose influences the way we breathe, so the operation must take into account the functional part.
What types of nasal tips are there?
- Bulbous tip: this tip occurs when the wing cartilages that give shape are larger than normal. The tip is large, rounded and broad. In general, patients with these tips have large alar cartilages that extend upward, taking up part of the space of the bridge of the nose. For the correction of a bulbous tip it is necessary to perform an open rhinoplasty, since it is easier to treat the alar cartilages. The first thing that is done is to reduce the size of these cartilages, with an excision of the excess cartilage. This excised cartilage can be reused to give a more harmonious shape to the alar cartilages of the new nasal tip.
- Forked tip: the split tip may be accompanied by a bulbous tip. This is a wide and not very thin tip, due to the separation of one alar cartilage with the contralateral one. In this case an open rhinoplasty is also performed, in this way one alar cartilage is sutured with the opposite one, in order to narrow the width of the nasal tip. The bifid and bulbous tips usually have alar cartilages that grow with the passage of time. This is due to the genetic load of each individual and may continue to grow after surgery. However, starting from a proportionate and smaller nasal tip.
- Drooping tip: the tip drooping over the upper lip is one of the characteristics that patients most frequently seek to correct. In many cases it is accompanied by difficulty in breathing, as the drooping tip closes the external nasal valve. In these cases it is necessary to reinforce the internal nasal valve, by means of spacer grafts that prevent the collapse of the nasal valves and improve the patient’s breathing.
- Asymmetric tip: occurs when one alar cartilage is not equal in shape or size to the contralateral one, causing a tip with asymmetries. In these cases, each of the areas of the alar cartilages is molded by suturing and carving them, achieving a nasal tip as symmetrical and harmonious as possible.
- Deviated nasal tip: it is very important to diagnose the origin of the deviation. In some cases it is only the nasal tip but it is necessary to rule out deviations in the bony area, especially in the quadrangular cartilage area. Although the treatment usually has a satisfactory result, there are cases in which the deviations partially return.
- Short tip: this occurs when the tip is poorly projected and the distance between the dome and the nasal base is small. It is corrected by strengthening the nasal column, which separates the two nostrils. Another option is to create an extension of the septum cartilage by grafting.
For more information about rhinoplasty you can contact a specialist in Plastic Surgery.