Sure, we can. Your situation is something that happens often after rhinoplasty and is one of the more common reasons that patients come to us for a revision. That’s because taking down a bony hump on your bridge is fairly straightforward. Techniques to make the nasal tip smaller are more advanced and many plastic surgeons are simply not comfortable with them. So, we frequently see people with persistent tip concerns after surgery elsewhere.

What you are asking for is referred to as a tip-plasty because the intended changes are only to the tip. That doesn’t necessarily mean that the procedure is less challenging but it will usually take a little less time than a rhinoplasty that also addresses additional concerns.

Your tip can be manipulated without affecting the rest of your nose. It sounds like you are looking for some deprojection of your tip to make it more refined and to bring it closer in to your face. We can do that in several ways, but the workhorse techniques for making these changes are called vertical dome division and lateral crural overlay.

The photos shown here demonstrate what a vertical dome division can do. The photo on the left is the Before view. The photo on the right shows a vertical dome division and overlap done on just the left tip cartilage. The right side was left untouched in this photo. If you compare the left to the right, you can see that the tip cartilage is shorter but retains its shape and contour. The overlapped edges are sewn together to maintain the strength of the tip. This is a powerful technique that can be used to reliably address a big or wide tip, a boxy tip, a droopy tip, a hanging tip, and any tip asymmetries or irregularities.

We won’t bore you with all the technical details. But, in both these techniques, the tip cartilages are made smaller by carefully cutting the cartilage, overlapping the edges, and suturing them together again. By doing that, the cartilage is made just as strong, if not stronger, so that the desired change will last for a lifetime without putting you at risk for collapse down the road. We choose which technique to use based on whether you also want your tip to be rotated up or down or other changes to be made. You can view the photos above to see how these techniques can decrease the size of your tip. Check out our Modern Rhinoplasty online textbook on our main site for more details.

If you see an experienced rhinoplasty surgeon, you should feel confident that your concern can be addressed in a very predictable and satisfying way.

Rhinoplasty is different for men and women in almost every respect starting out with facial aesthetics. While there is a lot of individual variation, facial aesthetics differ substantially between the sexes. In general, compared to women, the following features are considered more masculinizing and, therefore, more desirable for most men:

• a more acute nasofrontal angle (the angle between the forehead and the nose seen from the profile)
• a more acute nasolabial angle (the angle between the nose and the upper lip seen from profile - usually about 90-100 degrees)
• a straighter profile
• a higher bridge (even a slight bump)
• a more sharply defined, angular tip
• a longer nose
• more tip projection (the degree to which the tip juts out from the face)

In addition to the above, there are other factors we have to consider when contemplating Rhinoplasty in men vs. women. Men tend to have stronger, heavier cartilages and bone along with thicker skin in many cases. This will influence what needs to be done to create the desired changes and also the expected timeline of healing. We will vary our discussions with men depending on whether they have very strong, angular features or softer, rounder features. After all, the nose must fit the face. In general, though, men can tolerate a slightly high bridge and overprojected tip. By contrast, a male nose that is slightly scooped, too short, or too rounded does not go over well at all. So, we will always err on the side of maintaining a strong, masculine nose for male patients. There are some women who prefer and would benefit from some of these features, albeit to a lesser degree. Very tall women with longer faces, for example, usually look better with a straighter profile while very slight-featured, petite women can better tolerate a petite, softer, ‘cutesy’ nose.

This blog only begins to scratch the surface of the differences between the sexes when it comes to Rhinoplasty. And these only serve as the basis for our assessment in creating a highly individualized surgical plan for you.