Rhinoplasty is a common cosmetic procedure to reshape the nose so that it better fits with the patient’s other facial features and personal preferences. As part of the surgery, patients may elect to make changes to the tip of their nose. Referred to as tip plasty, there are several techniques surgeons may choose from based on the patient’s goals. Learning more about these techniques allows patients to make an informed decision about which technique may benefit them the most.

 

What is Tip Plasty?

This is a form of rhinoplasty, but the focus is on the cartilage of the nose and reshaping it. During this procedure, the nose bone is not altered. This can make the nose smaller or give the tip of the nose more definition. Patients might consider this procedure for the following:

• Reducing a nose tip that is large

• Augmenting a nose tip that is flat

• Lowering a nose tip that is upturned

• Uplifting a nose tip that is droopy

• Straightening a nose tip that is crooked

In some cases, this procedure might be considered for patients experiencing breathing troubles as a result of an abnormal nose tip. Refining the nose or reshaping it may make breathing easier. Sinus infections may also be more common in patients with an abnormal nose tip. Altering it may help to reduce sinus infection incidence.

There are several techniques a surgeon might use to accomplish a patient’s goals. On average, procedures take one to two hours. The surgeon will give the patient details about what to expect with the technique they will use.

 

 

Tip Plasty vs. Rhinoplasty

A traditional rhinoplasty puts most of the focus on the bone of the nose where tip plasty is focused on the cartilage. Patients who are seeking a smaller or subtler nose change that involves the tip of their nose and cartilage, this procedure may be an ideal choice. It can have a big impact on the aesthetic of the patient’s face, but the procedure is typically less involved compared to a traditional rhinoplasty, which may make recovery a bit easier to handle.

Ultimately, to decide whether tip plasty or a full rhinoplasty is the best choice, patients should consult with their cosmetic surgeon. Once the surgeon is able to examine the patient’s nose and face and understand what their cosmetic goals are, they can recommend which procedure is likely to provide the desired results.

 

 

Tip Plasty Techniques

There are several techniques surgeons might opt to use to reshape the cartilage elements of the nose. Knowing more about these allows patients to more easily work with their surgeon to achieve their desired result.

Intracartilaginous Technique

This is sometimes considered to be the most precise of all cartilage reshaping techniques that focus on the definition of the nasal tip. Some lower lateral cartilage is removed until the caudal margin is approximately six millimetres. This measurement helps to prevent nasal wall collapse or notching. To create a definition of the nasal tip, the surgeon will remove some of the cephalad lower lateral cartilage.

 

Lower Lateral Cartilage Technique

This technique works by essentially creating a guide with an imprint. The surgeon will put a suction tip in the area of the dome under the sculpting line. Putting pressure on the suction tip creates the imprint. This is used to guide the surgeon in reshaping the cartilage.

 

Joseph Technique

This technique involves removing part of the lower lateral cartilage. The surgeon will also transect the done. With the lower lateral cartilage that remains, geometric resection can be performed.

 

Non-Delivery Technique

With this technique, at the tip, there is just slight cephalic rotation and the lateral crus only gets a small volume reduction. The surgeon may use retrograde eversion or cartilage-splitting for this technique. For cartilage-splitting, resection of the lateral crus cephalic part is performed. The lateral crus should maintain a minimum of five millimetres of uninterrupted cartilage. Retrograde eversion is not often used due to more modern techniques being preferable.

 

Delivery Technique

This technique might be considered when the cartilage volume being reduced is larger. It may be done for asymmetry, extra cephalic tip rotation, bifidity or to reduce tip projection. Approaches may include:

• Precise cartilage excision

• Interdomal suturing

• Alar cartilage remodelling

• Alar cartilage continuity interruption

 

External Technique

This technique is often considered to give the most exposure, especially compared to the non-delivery and delivery techniques. Bimanual surgery is also possible with this approach. It may be considered for:

• Cleft nose, lip and other congenital deformities

• Severe nasal trauma

• Extensive revision surgery

• Elaborate augmentation and reduction procedures

 

 

Tip Plasty Recovery

On average, patients are able to go back to work within approximately one week of nose tip surgery. Their surgeon will provide at-home recovery guidelines that should be followed exactly to help with the healing and recovery process.

Since this is a surgery, there is a chance that risks may occur. Patients should know what these are so that they can prepare and look out for them. No matter the technique used, the risks are largely the same. Risks may include:

• Bleeding, numbness or scarring

• Deeper structure damage

• Allergic reaction to any anaesthesia used

• Chance of collapse

 

Author Bio:

Dr. Andres Bustillo is a reconstructive and facial plastic surgeon who is board certified. In the South Florida area, he is one of just a few subspecialist cosmetic surgeons. He operates his private practice and participates in the Faces of Honor and Face to Face Foundation to provide reconstructive surgery to those scarred from war and domestic violence.