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Tip Rhinoplasty Virginia

Changes to the nasal tip are often part of a “complete” Rhinoplasty. As result of a Rhinoplasty, the various parts of the nose (tip, nostrils, bridge, etc…) must all fit each other, and fit the face, of each patient. However, each patient’s face, nose, and needs are unique. Some patients have nearly perfect nasal tips and only need modification of the nasal bridge. Others have nearly perfect bridges and only need refinement of the tip. A few may only need alar reduction (nostril narrowing). While some need reshaping of the entire nose, and all of its parts. There is no “standard” or “one-size-fits-all” Rhinoplasty. Each nose is unique. And each Rhinoplasty should be based on the patient’s needs, goals, age, sex, race, facial features, as well as the Plastic Surgeon’s professional and artistic recommendations. Computer imaging is what merges all these components into the finalized Rhinoplasty surgical outline.

During a complete “top to bottom” Rhinoplasty, some Plastic Surgeons choose to first correct the nasal tip position and shape, and then match the rest of the nose to the new tip. Other Plastic Surgeons leave the reshaping of the nasal tip for the end after the bridge and dorsum have been modified. Regardless of approach, the end result must be a nose with all of its components in perfect harmony with each other and the rest of the face.

It is well known and accepted by most types of surgeons, and all Plastic Surgeons, that Rhinoplasty is amongst the most complex of all surgical procedures. There is no comparison between the technical complexity of procedures such as Liposuction, Breast Augmentation, Brow lift, and Rhinoplasty. Hence why a handful of Cosmetic Surgeons have dedicated their training and practice to Rhinoplasty near exclusively. Some surgeons have gone as far as boldly stating that Rhinoplasty is the most complex surgical procedure. Much of the reason behind such statements is the complexity of nasal tip Rhinoplasty. Reasonable and ethical Plastic Surgeons in support of this fact point out:

  • The complex three dimensional aspect of Rhinoplasty:
    • Changes to one facial view, result in changes to other views and vice versa. The Rhinoplasty surgeon must be able to visualize, predict, and plan for these interdependent changes
  • Rhinoplasty is an operation of millimeters or fractions thereof. There is no room for sloppiness or errors. Every surgical move must be meticulous and intentional.
  • Rhinoplasty results change after one week, to one month, to one year, to ten years after surgery, and the Rhinoplasty surgeon has to build a nose that will look better than the initial nose, for the life of the patient.
  • Dynamic and continually changing forces between the skin, cartilage, bone, and scar tissue, affect the results of Rhinoplasty
  • The results of Rhinoplasty sit on the middle of a patient’s face for the world to see. A bad nose job cannot be hidden by makeup or clothing.
  • Slight variations in surgical technique influence the result of the surgery.
  • A significant portion of highly trained and experience Board Certified Plastic Surgeons choose not to perform any Rhinoplasty or offer it in their practice, due to these factors; and instead refer patients to specialized Rhinoplasty surgeons.

Understanding and mastering the Rhinoplasty of the nasal tip is crucial for the Plastic Surgeon. Creating beautiful yet natural looking nasal tips is what patients desire. Pinched or fake nasal tips are unappealing and a thing of the past. Unfortunately, poor Rhinoplasty technique or over aggressive surgical resection by prominent experienced Plastic Surgeons today still result in such undesirable asymmetric or “pinched tips.”

Sometimes a Rhinoplasty surgeon may employ an open Rhinoplasty technique and spend hours creating a beautiful tip through the use of sutures, grafts, excisions and rearrangements of cartilage. Other times, a Rhinoplasty surgeon may use a closed Rhinoplasty technique and spend only minutes creating a beautiful nasal tip. The approach and the surgery depends on the starting point, the native symmetry or asymmetry of the patient’s tip, skin thickness, etc. The end point should be a natural, balanced tip with lack of any obvious signs of a Rhinoplasty.

Pic 1: Nasal Tip made up of the two Lower Lateral Cartilages

Pic 2: Nasal Tip forming a symmetric isosceles triangle

Pic 3: Lower Lateral Cartilages positioned slightly ahead (anterior) of the Upper Lateral Cartilages.