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Do you want to sharpen the tip of your nose? A rhinoplasty plastic surgeon may help you

February 01, 2018

Around the world, there are patients that are fairly satisfied with their nose's appearance, as they don't present any notorious hump or deviations that block the natural breathing process. However, there is a small detail that makes them uncomfortable: the tip of the nose. In some cases, it is too wide, too thin or with an orientation that they do not like, meaning, that the nose tip is downwards or too lifted. Thanks to my knowledge as a rhinoplasty plastic surgeon, I have years of experience applying esthetical techniques that correct this specific part of the nose, and my patients have been very happy with the results.

The alar cartilages or lower lateral cartilages are the part of the nasal anatomy that gives shape to the tip and offers support. When these cartilages have a very rounded shape, the tip of the nose looks wide. This is one of the most frequent concerns in my patients and that's why they visit my office. I usually present them the rhinoplasty technique that I apply to correct the tip of the nose and achieve a natural outcome.

Another reason why the patients have the tip of their nose wide is because the skin in this area is very thick. When this happens, its appearance is rounded. Commonly, I can identify the reason why the nose is wide, in the first medical evaluation, in my office. However, there are cases when I discover the cause in the operating room while performing the open rhinoplasty surgery.
What is the Rhinoplasty?It's a surgical procedure that I perform to operate the inner part of the nose. Applying various methods, I accomplish a better external appearance and make the patient satisfied with the tip of his/her nose.

Through this surgical procedure, I can perform several modifications. One of these is sharpen the tip of the nose; I accomplish it by molding the nasal alar cartilages through stitches. Some patients require cartilage grafts to achieve better results. For this plastic surgery, I apply local anesthesia with sedation, or general anesthesia if the patient requests it.

Also, I can elevate the tip of the nose by shortening the anterior portion of the septum, and modifying the cartilages of the nasal wings, fixing them with stitches. Some people wish to achieve the descent of the tip of the nose, in this case, I put skin grafts in the lower part of the septum or in front of the alar cartilages to give more length to the nose when the tip of the nose is too short, whether it is because a characteristic of the patient or a consequence of previous procedures that were poorly done.

There are two ways to do a rhinoplasty: open or closed. In my case, open rhinoplasty is my favorite and I try to perform it with all my patients, as this technique allows me to work better the inner part of the nose and achieve better results.
Open RhinoplastyI start this procedure with a small incision in the inferior central part of the nose, which links with the inside incisions of nasal wings to be able to lift the skin. The procedure helps me to access and visualize the internal structures of the nasal area to make the modifications the patient needs in the tip of the nose. When the person has a wide nose, I make changes in the bones of the nasal area to reduce its size. Instead, if the nose is too thin or short, I put cartilages grafts to improve the nasal structure and the tip of the nose. Open rhinoplasty allows me to have a better vision during the procedure, which doesn't happen with closed rhinoplasty.

Advantages of Open Rhinoplasty

• Unlimited access to alar cartilages.
• The little scar between nasal cavities will be barely visible after a while.
• Better modeling of the tip of the nose.
• Better results for the patients.

Closed RhinoplastyParticularly, I don't use this technique as it offers a limited access to the nose structures, which makes the intervention more difficult and the patient may not have the expected outcome. With this technique, small incisions are made in the inner part of nasal cavities to reach the bones and cartilages that constitute the nose. When the nasal tip is too wide, cartilage pieces can be removed or instead, stretch the tip of the nose through grafts and stitches, in order to model the cartilage and achieve a thinner nose.
Disadvantages of Closed Rhinoplasty

• Limited access to the patient's nasal structure.
• Thanks to the lack of scars, the procedure has limited techniques that don't allow to correct deformities or defects.
• Usually, specific changes that the patient requires cannot be made with this closed technique, especially those wanted for the tip of the nose.

ConsiderationsEvery patient has a different anatomy and when they come to my office to improve the tip of their nose, I, as a rhinoplasty surgeon, must determine what's the best technique according to the person's needs. In the first visit, I will make a medical evaluation to the patient and with the obtained results I will indicate the adequate process. In addition, the patient for rhinoplasty surgery should let me know his/her health condition, daily diet, training routine and if he/she is following any medical treatment. Also, it is very important to know if the patient smokes, as they must drop the habit a while before the plastic surgery.

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