Tip rhinoplasty (tipplasty) is an operation in which only the cartilage and soft tissue of the tip are reshaped, without working on the nasal bone. Ear, nose and throat specialist Op. Dr. Süleyman Kumbasar, whose practice is in Bahçelievler, Istanbul, determines at the consultation whether the concern is limited to the tip or needs a full rhinoplasty. It is usually done with the closed technique; bruising is usually limited, and the tip takes months to become defined, depending on skin thickness.
What is tip rhinoplasty?
Tip rhinoplasty (tipplasty) is an operation in which only the cartilage and soft tissue of the nasal tip are reshaped, without working on the nasal bone or the bridge. Lifting, narrowing or defining the tip and correcting its asymmetry are part of this surgery.
The tip is one of the areas that most affects how the nose looks. Because the bone is not touched, it is a more limited operation than a full rhinoplasty; even so, tip support also affects the airway, so it is planned with the same care.
Who is it suitable for?
It is suitable when the concern is limited to the tip and the bridge of the nose suits the face:
- A low or drooping tip; a tip that drops further when smiling
- A wide, rounded or poorly defined tip
- Asymmetry of the tip or the nostrils
- A narrow, pinched-looking tip
- Nostrils that are too visible from the front, or a tip that is over-rotated upwards
If there is a hump, wide nasal bones or a crooked bridge, surgery limited to the tip will not give a balanced result; a full rhinoplasty is then considered. Which one is right is decided at the consultation; the steps of the examination are described in the article what is assessed at a rhinoplasty consultation.
How is the operation done?
In most cases the closed technique is used: the incisions are inside the nostrils and there is no visible scar. When the tip needs extensive reconstruction, the open technique may be preferred, adding a small incision on the columella between the nostrils.
The tip cartilages are reshaped with suture techniques and reduced if needed. To keep the tip lifted, a small cartilage support (strut) can be placed in the columella, usually taken from the septum. Over-reducing the cartilage can lead over time to the tip sinking and the nostrils collapsing when breathing in, so preserving support is essential.
What is recovery like?
Because the bone is not touched, bruising around the eyes is usually limited and the return to daily life is quicker than after a full rhinoplasty. The tip, however, is the area where swelling takes longest to settle: it looks full in the first weeks and becomes defined over months. In thick skin this can take up to a year; the reason is explained in the article the nasal tip in thick skin.
Is there a non-surgical option?
Permanently lifting or narrowing the tip requires changing the cartilage structure, which needs surgery. Filler does not make the tip smaller and its effect is temporary.
What are the risks?
In addition to the general risks of bleeding, infection and anaesthesia, there may be prolonged swelling of the tip, minor asymmetry, temporary reduced sensation in the tip and a shape that does not meet expectations. If a problem persists, a further correction is usually considered no earlier than month 12 (see revision rhinoplasty). The risks are explained at the consultation before surgery and written informed consent is obtained.
The surgical process
General anaesthesia or, in selected cases, local anaesthesia with sedation; decided at the anaesthetic assessment.
Depending on the scope, usually 45 to 90 minutes.
Most patients go home on the same day.
Because the bone is not touched, packing is not usually needed. A dressing or small splint is placed on the nose and is usually removed between days 5 and 7.
Recovery timeline
Swelling and mild pain at the tip; bruising around the eyes is usually limited. Keeping the head raised is recommended.
The dressing or splint is removed and the stitches are checked. Most people return to office work during this period.
Recovery is enough for social life. The tip may still feel full and firm.
A large part of the swelling of the tip goes down; in thin skin the shape becomes defined sooner.
Final shape; in thick skin, the tip may take until this point to become defined.
Frequently asked questions
What is the difference between tip rhinoplasty and full rhinoplasty?
In tip rhinoplasty only the cartilage and soft tissue of the tip are worked on; the bone and bridge are left as they are. In a full rhinoplasty, if needed, the hump is removed and the nasal bones are also reshaped. If there is a hump or a crooked bridge, surgery limited to the tip is not enough.
Will I have bruising after tip rhinoplasty?
Because the nasal bones are not touched, most patients have no bruising around the eyes, or only mild, short-lived bruising. Swelling of the tip, however, lasts longer.
Will the tip drop again after the operation?
Whether the tip keeps its position over the long term depends on leaving firm cartilage support. That is why the cartilage is not over-reduced and, if needed, a cartilage support is placed in the columella. Slight settling of the tip during recovery is expected and is allowed for in planning.
Can a tip that drops when smiling be corrected?
When smiling, the pull of a muscle of the upper lip on the base of the nose can make the tip drop. When indicated, this effect can be reduced during tip surgery. The assessment is made at the consultation by observing facial movement.
Does tip rhinoplasty affect breathing?
If it is well planned, breathing is not expected to get worse. However, over-reducing the tip cartilage can make the nostrils collapse when breathing in, so support is preserved. If there is also a deviated septum, it can be treated in the same operation.
At what age can tip rhinoplasty be done?
We wait until the nose has finished developing. For cosmetic surgery the reference is being 18 or older; there is no upper limit, and the decision depends on general health.
Related treatments
Articles on this topic
Sources
- Ishii LE et al. Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty. Otolaryngology–Head and Neck Surgery, 2017.
The information on this page is for general guidance only; diagnosis and treatment decisions are made by the doctor after a consultation. Results of surgical and interventional procedures vary from person to person.