Mar 20

Rhinoplasty, Tip grafts, Increased Projection and the Apparent Nasal Bump

Occasionally we get young and often times older patients who present and tell us that after years of staring at their profile in the mirror that they are now noticing a bump when they did not have one before.

In most cases this apparent bump is due to a loss in tip projection.  As we age, we lose some tip support and for some the result is a tip drop and an apparent bump. Many of you may have noticed a grand parent who seems to have a nose that had grown over the years and has developed a bump. The fact is that the nose has not actually grown. As the tip has lost support, it has started to droop resulting in a longer nose and oftentimes in a new bump.  See our online textbook for more details (the Aging Nose)

In some cases a tip graft alone is all that is needed but there are other suture techniques that can also increase tip projection without using grafts (that can sometimes cause problems long term). The key is to look at the nose in all its dimensions and get a real sense of what is needed. Some may think of using nasal fillers, but while this may help the profile view in short term, on front view the nose will often look fuller/ bigger and less defined (not to mention the potential risks- nasal fillers

Finally, since we have a niche rhinoplasty/ revision rhinoplasty practice, my strongest advice would be to go to a facial plastic surgeon/ general plastic surgeon who does a lot of rhinoplasty and try not to have cost be the overriding factor. Not that you have to go with the most expensive by any means, but in the long run we think the time, money and emotional investment that can come with having to go through revision is far outweighed by going to someone who does it right the first time.

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