A nose job or rhinoplasty (Greek: ῥίς rhis, nose + πλάσσειν plassin, to shape), is a delicate work of art that requires clear communication of desired results and a solid pre-operative strategy to achieve the best results. Rhinoplasty is an operation that is a sum of its parts. The various parts of the nose need to be brought to a perfect harmony. Should tip work be performed, then in all likelihood that the nasal dorsum needs to be recontoured to properly align with the newly created tip. The width of the nasal bones will probably need attention as well. Welcome to delicate balance that is Rhinoplasty!
Patients often present with large bulbous tips for rhinoplasty. Rhinoplasty can change the shape of the nose by removing/adding structural elements. There is some skin retraction following rhinoplasty. After all, once a bump is taken down or a tip cartilage removed, where does the extra skin go?
Often, the patient who has a big nasal tip has thick skin. The rhinoplasty surgery does not really address this issue. Excess skin/tip width can often reduced by reducing the alar base width which is removing part of the nostril.
We still do not have the ability to decrease large excess and thickness of skin on the nose without causing severe changes to the nose. There are surgeries to help but it is difficult to control scar formation and further thickening of the skin.
By changing the structure of the nose by altering its cartilaginous or bony framework will make a smaller nose, but still a thick nose.
There are patients where "most" of the work needs to be addressed at the tip. Those patients require more tip work than others but still often need surgical refinement of their nasal dorsum, nasal bones, etc.
I have been performing Rhinoplasty for more than 20 years. It is a procedure that you continue to learn to perform better. If you want to learn more I invite you to leave a comment and contact my office.
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