Think of the tip cartilages like a pair of wings. You can get an idea of what these look like from the photos below. The tip cartilages (lower lateral cartrilages) are like a bent spring that holds the nostril’s shape and keeps it open to allow normal breathing. In many poorly done rhinoplasties, this cartilage is aggressively cut or removed so that it loses this natural spring. Over time, whatever cartilage is left starts to bend and twist under the weight of the skin. As the cartilage twists on itself, the weak points at the ‘joints’ of this cartilage can start to form bumps or knuckles, called bossae, that are very noticeable through the skin. Check out the diagram below to see what we mean.

In the photos above, you can see normal anatomy of the tip cartilages on the left. The center photo shows the weakened and twisted cartilages commonly found after over-aggressive cartilage removal. The corresponding bumps (bossae) seen on the surface are shown by the arrows on the right.

Many surgeons treat these bossae by going back and trimming them, weakening the cartilage even more. Anyone can appreciate that this is probably not a good long-term solution. The Beverly Hills Rhinoplasty experts at Profiles know that the tip cartilages must be reconstructed in order to restore their natural strength and resiliency while improving on the cosmetic appearance of the tip. The photos below show the above Revision Rhinoplasty patient treated at Profiles to take care of her tip bossae and other post-rhinoplasty concerns highlighted in the next few sections.

Above is shown a before and after photo of a Profiles Revision Rhinoplasty to treat a twisted tip with tip bossae.