Question:
What is a bulbous tip?
Answer:
Dr. Becker examines your nose and determines what he feels would be the best techniques to address your bulbous tip. Two approaches – suture techniques and cephalic resection – are described here. At times, other less commonly used techniques may be appropriate. Dr. Becker will explain to you the techniques he plans to use and his reasons for choosing them.
There are several techniques used to narrow or refine a bulbous tip. Often, more than one approach is used to achieve the desired narrowing: One approach is a sutures technique, in which the tip cartilages are repositioned or bent using suture. This causes the cartilages to heal in a new, narrower position, and the surrounding skin heals around the cartilage to give your tip a new, narrower appearance.
Suture techniques: Suture techniques represent a conservative and reliable way to make changes to the nasal tip. Suture techniques can be instrumental in refining a bulbous nasal tip. Suture techniques can also facilitate tip elevation (projection and rotation).
Suture techniques have become increasingly popular because they are reliable. Also, since there is no resection of tissue with this technique, it is felt that these techniques are relatively safe when performed by skillful surgeons. The patient shown below had a bulbous tip, addressed with suture techniques:
Another approach involves removing a portion of the tip cartilage (“cephalic trim”). This volumetric reduction of tip cartilage allows the surrounding skin to heal around it in such a way as to contribute to a narrower appearance.
Cephalic resection: To help achieve refinement or “narrowing” of the nasal tip, a resection of portion of the tip cartilage may be undertaken. Known by surgeons as “cephalic resection,” This technique is another important and useful method to refine the bulbous tip.
Here is an example of a patient whose bulbous tip was addressed simply with cephalic resection:
When performing a cephalic resection, rhinoplasty surgeons must carefully judge how much to take, and how much to leave behind. It is critical that the surgeon not take too much. There are general guidelines of how much is too much, but each patient is different and the strength of each patient’s cartilages must be carefully considered. If a patient has thin, soft, weak cartilages, very little if any cephalic resection should be undertaken.