Naturally, every patient hopes to get the nose of his or her dreams after undergoing rhinoplasty surgery. Unfortunately, not all rhinoplasty procedures go according to plan. Due to the complex and difficult nature of the surgery, rhinoplasty has the highest rate of revision among popular cosmetic surgeries. Because the nose is a dominant facial feature that boasts a complex internal structure and an extremely important functional role, a less than ideal outcome can, at best, produce a poor aesthetic outcome. At worst, it can create functional problems that impede breathing or produce a deformity in the nose. There are many deformities that revision rhinoplasty surgeons have to deal with, and one of the most common is known as the “polly beak” deformity.
What is Polly Beak Deformity?
A polly beak deformity describes a nose that reaches a high point at the part of the bridge right above the tip (known as the supratip). This, combined with a downward curve of the nasal tip, forms an appearance similar to that of a parrot’s beak. This is most obvious from the profile view from which the supratip appears to be the highest point of the nose.
How Does a Polly Beak Deformity Occur?
In the era of predominantly open rhinoplasty polly beak is less common than in the past. Even in the best surgical hands, some causes include:
• Removing bone and cartilage from a dorsal hump without reducing the top of the septum sufficiently.
• Unpredictable excess scar formation in the supratip area
• Settling in of the tip of the nose more than predicted at the time of surgery.
• Less than optimal support of the tip of the nose after surgery.
Polly beak is more likely to occur in patients who:
• Have thick skin
• Have soft nasal cartilage
• Experience poor healing following rhinoplasty
• Received insufficient hump reduction
Surgical Techniques for Treating Polly Beak Deformity
While each patient’s case is unique and a custom approach should always be taken, there are a few ways surgeons can treat a polly beak during revision rhinoplasty.
• Injection of a steroid called triamcinolone into excess scar one or more times
• Trimming the septum and cartilage in the bridge area
• Adding or removing cartilage to the tip
• Supporting the bridge with dorsal grafts
• Balancing bridge height
Revision Rhinoplasty for Polly Beak Deformity
Revision rhinoplasty is a fairly common procedure, and many surgeons offer the surgery. Be aware, however, that the complexity of revision rhinoplasty is still greater than that of primary rhinoplasty due to scar tissue formed by the first surgery, weakened structures, and less cartilage to harvest from. Only a rhinoplasty and revision specialist has this expertise,
Choosing a Surgeon for Polly Beak Deformity
Assuming your original surgeon is a rhinoplasty specialist, the best person to do your revision is the original surgeon. With each subsequent rhinoplasty, it becomes more and more difficult for even a skilled surgeon to produce a good aesthetic outcome.
If you have decided you want a new surgeon and you are looking for an acclaimed rhinoplasty specialist in the Boston area, consider a consultation with double board-certified facial plastic surgeon Dr. Stuart Bentkover. Dr. Bentkover has dedicated himself to the art of rhinoplasty, and has many years of experience working with all types of patients. Dr. Bentkover’s results speak for themselves, and you can find examples of his work by viewing his before and after rhinoplasty photo gallery.