Rhinoplasty is the surgical modification of the shape of the nose, also known as a “nose job” or nose reshaping. Tip-only rhinoplasty involves modifying the shape and orientation of the cartilages in the tip of the nose and is a quicker and less expensive option for patients who only desire changes to this area. These include the lower lateral cartilages, which make up the bulk of the tip volume, as well as the end of the nasal septum. Tip-only rhinoplasty surgery can be used for a variety of changes. Most commonly, patients want to make the tip smaller and more shapely, more straight and less droopy, or shorter (doesn’t stick out as much from the face). In a smaller number of cases, patients want the nose to be more projected or longer. For this group, cartilage grafts may be used to give the tip more definition or projection. Lastly, the nostril shape and size may be changed during the procedure as well; this is called alar base modification.
Most tip-only rhinoplasty procedures are performed with the open approach. This involves a small incision placed in the columella (the skin between the two nostrils at the bottom of the nose) and affords better exposure of the delicate tip cartilage. This allows accurate assessment of the underlying issues with the shape of the nose, as well as precise modification of the cartilage. Dr. Ransom can reduce the size of the cartilages, change their orientation, make the two sides symmetric, and most importantly, support the internal structure of the nose in order to create a more aesthetically pleasing shape for the tip.
Dr. Ransom works with each individual patient to create the nose that they have always wanted. Computer imaging is used in each consultation to help you define the changes to your nose that you desire. This technology lets patients “try on” a new nose in the context of their own facial features before having surgery. Different noses work for different faces, and Dr. Ransom is sensitive to his patients’ need to “look like me” after the surgery.
Anyone who wants to change the shape of the tip of their nose may be a candidate for tip-only rhinoplasty. Tip-only rhinoplasty involves reshaping the cartilage at the tip of the nose. No changes are made to the bridge of the nose, including the nasal bones. If you have a “bump” (dorsal hump) that needs to be addressed, a full rhinoplasty is required. Also, patients who have had a previous rhinoplasty and are seeking further changes would require a revision rhinoplasty procedure. Tip-only nose reshaping can be used to make the tip smaller and more shapely, more straight and less droopy, or shorter (less projected). In some cases, grafts may be used to give the tip more definition or projection. The nostril shape and size may be changed also. Dr. Ransom works closely with all of his patients, to make sure that the changes made to your nose reflect your goals and to ensure a smooth healing process.
Frequently Asked Questions
During the healing phase after your procedure, there will be some swelling inside the nose. This may cause a temporary feeling of “stuffiness” or congestion. After the swelling resolves, there should not be any changes to your breathing. Dr. Ransom is a specialist in nose form and function, and he uses this knowledge to make sure that his patients’ breathing is not negatively affected during rhinoplasty. Any issues pertaining to breathing should be discussed during your rhinoplasty consultation. For patients that need surgical improvement of the breathing, a more comprehensive operation is indicated. Cosmetic changes and functional surgery can be combined, however, and we are more than happy to help you with both.
For most patients, the initial recovery is quick – typically a week. Due to swelling inside the nose, many patients feel “stuffed up” or congested for a few days. Bruising is generally minimal with tip-only rhinoplasty since the nose bones are not broken. The tip of the nose will be swollen, though much of this resolves over the first week or so. Some swelling will persist, however, and will take a while longer to go away completely. Pain is minimal and Dr. Ransom does not use nasal packing, making recovery more comfortable for his patients. Most plastic surgeons agree that the final result of a rhinoplasty is not seen for at least six months, and it is common to see subtle changes up to a year from the surgery.
In many cases, you will have a cast on the nose for about a week after the procedure. This protects the nose from accidental trauma and also helps reduce some of the swelling that occurs after surgery. Dr. Ransom does not use any nasal packing, which allows the patient to breathe normally and significantly reduces discomfort. Your nose may feel “stuffy” for a few days, but this resolves quickly. Pain is generally minimal. You will likely feel tired for a couple of days and should limit your activities in order to concentrate on recovery and healing.
Dr. Evan Ransom is an Ivy League-educated and Ivy League trained Facial Plastic and Reconstructive Surgeon. He is a Double Board Certified Head and Neck Surgeon and Facial Plastic and Reconstructive Surgery and fellowship-trained in facial plastic, reconstructive, and laser surgery. His practice is in the San Francisco Bay Area, serving patients from San Francisco, Oakland, Marin County, Palo Alto, Silicon Valley, Walnut Creek, the East Bay, and all over Northern California.