Dr. Young Award Winning Facial Plastic Surgeon Discusses Nasal Tip Refinement, Nose Tip Surgery in More Detail:

The nose is located in the center of the face and is one of the major structures that people use to determine beauty. It should blend in symmetrically with the rest of the face. When someone looks at you, they usually start at the eyes and then they proceed to evaluate your nose and mouth. Then they evaluate if everything fits nicely and is symmetric, whether the shapes relate to each other in a balanced way, and that there are no objects in the face that attract too much attention. Your Nasal Tip is one of the major shapes within the face. The other two shapes that are equally or more important are your iris and the central portion of the lower lip. With a Nasal Tip that is less than ideal in appearance, your general facial beauty may be interpreted to be less than optimal. The ideal size of the nasal tip should be about one iris width in shape and dimension. If it is less than or more than this, the nasal tip is less than ideal. A Rhinoplasty is the best way to shape your nose to refine the nasal tip. We will talk more about this process here. You can learn more about Dr Young's Theory of Facial Beauty, called the Circles of Prominence. If you are interested in setting up a consultation you can email or call us (425.990.3223) at any point during your reading about Rhinoplasty. You can also find out more about our consultation process here.

The nasal tip is made up of mostly cartilage and also soft tissue such as fat, and skin. It is formed by the shape of the lower lateral cartilages (see below lateral and medial crus). The lower lateral cartilages has a tremendous impact on how the nasal tip will look like. Rhinoplasty techniques concentrate on refining this cartilage in order to shape the nasal tip. Below is a picture that shows you the anatomy to help better understand what we are talking about.

As we mentioned in our previous discussion on Rhinoplasty, we usually do this procedure through an open approach. After making the incision, we carefully expose all the cartilage underneath and then we shape the cartilage by taking out the superior portion of the lateral crus to make the general size of the nasal tip smaller (cephalic trim). Then through non destructive techniques, we use sutures (that are reversible) to shape the cartilage as desired. This is in contrast to older techniques that use destructive excision of the cartilage, morselizing, and other forms of weakening the cartilage. These older techniques are less predictable and often lead to bumps and shapes that were undesirable. Revising these older techniques often required reconstructive approaches that are much more involved.

After this is done, your small incisions are closed with very fine sutures. We also usually have a tape and splint to protect your nose for the first 6-7 days. We almost always avoid packing in your nose. We can do this because we have a special way to close the whole area to keep things fitted over the septum and forgo the packing. Also we have a special way to close your incisions so that the nasal skin is fitted on to the underlying structures. These tacking stitches helps your healing much better than traditional approaches that rely on taping the nose for long periods after your Rhinoplasty. Below is an example of a person who underwent Nasal Tip Refinement Rhinoplasty with Dr Young:

In this before and after, we show that we raised the Nasal tip and also refined the area for a more pleasing appearance. TheNasal Tip was shortened to decrease the hook and hanging look in the before picture and Tip was also rotated upwards. In addition to the Nasal Tip Refinement, the Nasal Bridge was reduced to decrease its prominence. This Rhinoplasty was done with the open approach. Notice that the incisions are hard to detect.

These are before and after pictures that shows Nasal Tip Refinement for an Asian Nose. The Nasal Tip was refined by sutures non destructively and it was also refined with the help of medpor (porous polyethylene). This Medpor Implant was used to advance the nasal tip cartilages forward and in a longer position to make the tips smaller and to lengthen the nose. This nose also had a Medpor Implant placed in the nasal bridge area to raise the bridge and create more enhancement in this location. The skin and area covering the nostrils were also refined through an excision of skin next to the nostrils to elevate the area, decreasing the hanging of the nostril skin. The nostril is shown more as you look from the side and the appearance of this area of this person's nose is enhanced.