Rhinoplasty for a Rhinoplasty for a Bulbous Tip

Bulbous tip noses that have thick nasal tip skin can still be refined despite the thickness of the nasal tip skin. This can be done with tip cartilage shaping, suture techniques, and using cartilage grafts from the septum after septoplasty, even for a deviated septum. The subcutaneous fat and muscle can also be reduced around the tip skin in order to create a more defined tip. However, even with these techniques, the bulbous tip with thick skin is still difficult to refine as much as one with thin skin. 

This is one of the most common questions we receive from patients considering rhinoplasty. The cost of a bulbous tip rhinoplasty will vary on many factors. Since refining the tip of the nose is a cosmetic change, this may not be covered by your insurance. Fees will include the surgeon's, anesthesia, and facility fees for these aesthetic changes desired.

If you have breathing problems due to a deviated septum, allergies, or repeated sinus infections that require surgery, this portion of your surgery will be paid by your insurance (depending on the extent of your benefits). This will fray the cost of cosmetic fees for the facility where Dr. Funk performs surgery and the anesthesia fees. The majority of their bill will be paid by your insurance company (again, depending on your insurance benefits).

Many of my Houston rhinoplasty patients are concerned about their bulbous tip and would like a more refined nasal tip. Bulbous tip causes are most frequently due to misshaped cartilages that form and support the tip of the nose. The cartilages can be too wide, have too much “spring” to them, too much convexity, or simply be too widely spread apart.

Another cause of a bulbous nasal tip could be the thickness of the overlying skin. This is especially true with my Houston ethnic rhinoplasty patients. Reshaping the cartilages and debulking of the skin are two methods to create a more refined nasal tip. Lastly, small cartilage grafts from a corrected deviated septum can also be used to refine the tip.

Treating the bulbous tip with rhinoplasty is done by removing small edges of the cartilage to refine them and using suturing techniques to create a sharper but yet natural nasal tip. Sometimes, cartilage grafts are necessary to create a more refined nasal tip in patients. Lastly, thinning of the nasal tip skin may be necessary for thick skinned patients.

Some patients may want to adjust just the tip of their nose as opposed to a full rhinoplasty. What is important to note regarding rhinoplasty is that the nose is like a puzzle. If you change one shape of the puzzle, you must change the subsequent shapes. So, if you narrow the nasal tip, then you may need to narrow the nasal bones and the nostrils. If you bring the tip in or shorten the nose, you may need to take the bridge down to adjust for this.

This is why a tip rhinoplasty alone is fairly rare and should be preserved only for those patients who do not need adjustments made to the rest of the nose for balance.

Some patients come to see Dr. Funk for a revision rhinoplasty after a nose surgery with another surgeon. They may still be concerned about the tip of their nose and want more refinement of the nasal tip. A revision rhinoplasty for a bulbous tip depends on many things regarding their previous surgeries.  

Patients with thicker nasal tip skin may develop more scarring beneath the skin which can make refining the nasal tip more difficult.  Patients who have had multiple nose surgeries will also have more scar tissue as will patients who have had an open rhinoplasty approach.

A consultation to discuss expectations is always best in this case and can be scheduled by contacting our office. 

Recovery is eight days. On day six after surgery, Dr. Funk will remove your cast and some stitches. He will retape your nose and on day eight after surgery he will remove that tape and all the stitches. You are social at this point! Most if not all of your bruising is gone by then. The nose will be swollen at this point but not noticeable to others. As the months pass by, your swelling will decline. At 3 weeks, 20-30% of swelling is down. At 6 weeks 50-60% of swelling has abated. It will take a full year for all the swelling to subside. However, most of Dr. Funk's patients are thrilled with the appearance of their once the tape comes off and know it will only get smaller over time.