Wide Nose Contouring

The wide nasal tip or bulbous tip is a common complaint among patients seeking rhinoplasty.  This is usually the result of enlarged lower lateral cartilages.

Diagnosis

Dr. Bray, Jr. will perform a detailed nasal and facial examination.  Photographs will be taken to allow further analysis of the nasal and facial proportions.   It is important to analyze the entire nose in order to evaluate the width of the tip in relation to the upper and middle thirds of the nose.  The tip projection and rotation must also be evaluated.  The nasal tip cartilages will be palpated and assessed for any asymmetry.

An internal nasal exam will be performed to evaluate the nasal septum and turbinates.  The status of the internal and external nasal valves will be assessed.

Nose Tip Surgery

An open rhinoplasty approach is usually used.  The nasal tip cartilages may be modified by suture techniques.  The domes may be narrowed and pulled closer together with sutures.  In most cases the enlarged nasal tip cartilages are also trimmed along their cephalic border.  This maneuver will help narrow the wide tip, but can only be performed when the lower lateral cartilages are sufficiently large.  The width must be greater than 6-7mm.  Cephalic trim may also increase tip rotation and should be avoided if the patient has an over rotated tip.  The goal is to provide a more aesthetic narrow tip while avoiding a pinched tip which could compromise the nasal airway.

Postoperative

The postoperative course is similar to other rhinoplasty procedures. Before/after images of Dr Bray, Jr.’s rhinoplasty work is in the image gallery.