People seek rhinoplasty for all sorts of reasons. The nose is a complex structure, and can exhibit many different deformities, cosmetic issues, and breathing problems.
Some of the more common reasons people seek cosmetic nasal surgery are to correct a bump or hump on the nose, increase or decrease the size of the nose, straighten a crooked nose, or change the shape of the nasal tip.
In some cases, the nasal tip is under-projected, meaning that it does not extend far enough out from the face for a symmetrical, aesthetically pleasing, and balanced appearance. Ideally, the nasal tip should be the highest point of the nose, but this is not so with an under-projected tip.To make matters worse, this problem is often accompanied by a lack of definition or shape in the nasal tip.
Common Reasons for Under-Projected Nasal Tip
There are a number of reasons why the nasal tip may be under-projected, but there are two major causes. They are:
Polly Beak Deformity
Usually caused by a prior rhinoplasty procedure, a polly beak deformity occurs when the nasal septum is left too high, when the upper or lower cartilages of the nasal tip are left too high, or when thick scar forms in the area just above the tip (called the supratip). The polly beak is easiest to see from the profile view. Polly beak can also occur when the nasal tip does not have sufficient support, or following insufficient resection of a nasal hump.
A dorsal hump is a bony hump or bump on the bridge of the nose, often making the nose appear larger than it actually is. Because the top of the dorsal hump is often the highest point of the nose, it can make the nasal tip appear under-projected or droopy. In these cases, repair generally involves both work on the nasal bridge and the nasal tip.
Many people with nasal tip projection complaints are interested in nasal tip rhinoplasty to raise the tip to promote facial symmetryand improve nasal aesthetics. To add projection to the nasal tip, a surgeon may use a grafting technique to move cartilage from the nasal septum, ear, or rib, to the nasal tip for added projection and definition.
Sometimes, the desired results can be achieved using the “closed” rhinoplasty approach, which involves no external scars. However, many modern rhinoplasty experts prefer the “open” method, which increases visibility and maneuverability.
In many cases, tip rhinoplasty alone may not be the best approach to an under-projected tip, such as in cases where a dorsal hump makes the tip appear underprojected. There are many techniques that can be used to achieve each patient’s goals, as rhinoplasty is a complex procedure involving nasal structures, cartilage, and bone. In order to produce lasting results, simple cartilage grafts to the nasal tip may not be the best way to address the projection problem, and more extensive work on the rest of the nose may be required.
Only a qualified rhinoplasty specialist has the knowledge to make a plan for surgery according to the patient’s goals and nasal structure. If you are interested in rhinoplasty, you should choose a surgeon you can put your trust in to plan and perform the procedure so you get what you want. Keep in mind, however, that rhinoplasty is meant to create marked improvement, not perfection, and keeping expectations realistic is part of the key to success.
Planning Your Surgery
If you are ready to start discussing options with a qualified rhinoplasty specialist, then it is time to schedule consultations with board certified facial plastic surgeons who have dedicated a great deal of time and energy to their rhinoplasty skills. Choosing your surgeon is the most important decision you will make in the rhinoplasty process, so do not skimp on the research phase.
Not sure where to start? Dr. Stuart Bentkover of Bentkover Facial Plastic Surgery in Worcester (508-363-6500) and Stoneham (617-247-0033), MA, is an acclaimed rhinoplasty expert, having dedicated over 25 years to honing the art of rhinoplasty. For more information, call either location today to schedule your consultation.