The difficulty of treating the nasal tip in a rhinoplasty

In today’s video, Dr. Fernández Blanco is going to talk to us about rhinoplasty, specifically the nasal tip and the complexity and difficulty involved in shaping the alar cartilages, and when it is necessary to use a closed or open technique. If you want to know more about nasal tip rhinoplasty, don’t hesitate to ask in the comments. And as always, if you know someone interested in our treatments, please tag them. You can see more before and after photos of a nasal rhinoplasty here.

Why is the nasal tip so complicated to operate on?

The nasal tip is the most important and the most difficult part to treat in rhinoplasty. The nasal tip is made up of two arches (like the arches of a cathedral): these are the alar cartilages. The alar cartilages are arranged one to the right and the other to the left; they are normally symmetrical and the same size, but sometimes they are very irregular in shape. In these cases we can treat it with open or closed nasal tip rhinoplasty.

Closed nasal tip rhinoplasty cases

This technique is performed through an incision inside the nose, removing the affected cartilaginous part. As the cartilages are symmetrical, the result is symmetrical and, with minimal undermining, we achieve a very satisfactory result.

Open nasal tip rhinoplasty cases

When the alar cartilages have a large projection, that is, they are irregular, we have to treat them in depth. In this case, an open rhinoplasty is required. The open technique allows us to see the cartilages in more detail, which means that when reshaping the nose, what we leave is symmetrical and to our liking.

Secondary rhinoplasty cases

It is important to talk about the procedure that will be performed to touch up the nose tip. Secondary nasal tip rhinoplasty cases, in almost one hundred percent of cases, must be procedures using the open nasal tip rhinoplasty technique. This is because no more information is known than how the cartilages we are going to treat have been left. When it is in our center, if on the first occasion, with a closed tip rhinoplasty, we could not fix the alar cartilages, we are obliged to perform an open surgery. That is the reason why in almost 70% of our patients we choose open rhinoplasty.

In conclusion

The tip is the element that will determine the proportion of the rest of the nose, and the dorsum must be in harmony with the tip. A large tip projection requires having a nose with a large nasal dorsum. A small tip projection allows you to have a much smaller nose and does not allow a significant reduction of the nasal dorsum.

In short, the tip is the area that presents the most surgical defects in a secondary rhinoplasty to touch up the nose tip. Almost all the patients we treat for secondary rhinoplasty have defects in the nasal tip, so a great deal of attention must be paid to its treatment.

Recovery from a nasal tip rhinoplasty

Recovery consists of:

1. One week of immobilization with a splint
2. Another week with surgical tape
3. After two weeks we can see part of the result of the rhinoplasty and the patient is usually happy. At this point there is no bruising, or it is minimal.
4. You have to bear in mind that the nasal tip remains hard for months, and the final result to the touch will not be seen until after 6 months or a year.