Rhinoplasty Surgery - Reduction/Removing a Bulbous Nasal Tip - Nose Job
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- เผยแพร่เมื่อ 8 เม.ย. 2020
- Rhinoplasty Surgery - Reduction/Removing a Bulbous Nasal Tip - Rhinoplasty by Dr William Portuese. www.seattlefacial.com/ 👨⚕️⚕️
Today we're going to talk about reduction of the bulbous nasal tip. The bulbous nasal tip can be caused from a variety of issues. It can be caused from thick skin which we really can't do much about because rhinoplasty involves cartilage surgery, not skin surgery. So, if you have really thick skin, you're probably not a candidate for a bulbous-tip rhinoplasty.
However, if the the bulbous nasal tip is caused by thick and wide and divergent cartilages in the tip of the nose, we can refine those tip cartilages with a combination of suture techniques. And these sutures last about four to six months, holding the cartilages together to narrow and refine the tip cartilages. And then we also perform a conservative cartilage removal so that the width and the bulk of the tip is reduced. The suture techniques that we use to reduce the bulbous tip are really a powerful tool that allows us to give a natural appearance. It's still the patient's own cartilages; just, it's sutured together to give a more narrowed and refined appearance. But the sutures are what's important to hold those cartilages in those newer positions that are more narrower and refined and less bulbous. www.seattlefacial.com/procedu...
The bulbous nasal tip involves suture techniques and conservative cartilage removal, and usually osteotomies and sometimes spreader grafts placed in the nose. So it's a lot of work. Therefore, the nose is swollen for a considerable period of time. And especially so because we did so much work on the tip itself. So the tip itself stays swollen for the longest period of time, approximately 70% of the swelling is gone at a month after the surgery, about 90% is gone about three months after the surgery, but full healing takes a year. And some patients who have thick skin in the tip of the nose, will require some steroid shots to ensure that the soft tissue envelope over the framework of the nose heals in a fashion such that it's balanced. Because when you do these techniques in patients with thick skin, there will be an extended amount of swelling left on the inside of the nose. After the bulbous tip reduction surgery with those suture techniques, it doesn't look like I did anything to the nose tip for at least a couple of weeks because it's too swollen, because all the work we had to do to reduce that bulbous nasal tip. So, the swelling is such that it doesn't look like I did much. But you start to see what that nose looks like at about a month, and patients really start to see what it looks like at about three months. The bulbous nasal tip surgery will make the tip of the nose significantly narrower, which will balance with the remainder of the nose depending upon if there's a dorsal hump or a wide bridge. But all we're trying to do is, when patients have a really bulbous nasal tip, it's usually the first thing that everybody sees. And we're trying to just make sure that that bulbous tip is refined such that it blends in with the patient's facial features. After the bulbous tip reduction, the nose does look smaller after the rhinoplasty surgery. So this patient presented to us with complaints of a very large, wide, boxy, and bulbous nasal tip. In addition, if you notice right above her boxy tip, she was really pinched in the mid portion of her nose, and then she had wide nasal bones. So what we did was, through a closed-rhinoplasty approach, went in and did a conservative cartilage removal in that nasal tip. And then placed some sutures between the two nasal tip cartilages to reduce the 'bulbousness', to give a significant amount of refinement to that nasal tip. And so I also put... Just above that bulbous tip, I also put a little patient's own cartilage called a spreader graft in that area, which transitions the bridge to the tip, and actually builds out that pinched area right above the tip itself, which also helps reduce the amount of look of the bulbous nasal tip itself. She also underwent a hump reduction and placement of osteotomies which are cuts in the nasal bones to narrow the bridge line, so that the nose looks good in all three dimensions, you know side, three-quarter, and front.
Dr William Portuese
1101 Madison St 1280
Seattle, WA, 98104 USA
206-624-6200
www.seattlefacial.com
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My nose is weird when I use my muscles on my nose my nose looks pretty...but otherwise it looks bulbous(even everyone I know says my nose is not big I feel like it is.)
OH MY GOD SAME
Yeap. Same here. I haven’t got a big nose, but the tip is bigger than the upper part (unless I move my muscles and then the whole nose seems the same size for some reason)
Same
@@mariamatmos4506too accurate
Amazing how rhino surgery can completely change the look of the face and for the better.
This doctor has some amazing results.
Last patient is stunning after the surgery
Wow Doc your work is beautifully done. Thank you for sharing all the info too
I'm a 19 year old boy.. I have a nose very similar to those pictures.. And I can feel my cartilages at the tip very clearly.. 😭😭😭😭😭
Same
I saw your pfp your gorgeous! Are you seeking attention bec you don't look ugly to me?
@@ezitthbjorn no. My nose really looks like a piggy nose. That camera angle makes it look small. Everyone in my family tell me that my nose is bigg. Actually only the front tip is big
Same bro
I’m 30 now
Don’t wait that long, get the money saved an go get your full-confidence once you can
or become comfortable with it, ofcourse but: I still can’t
How much cost
Very informative!
Thank you for taking the time to give such an in-depth video!
The end result is beautiful 😍
Good 👍 job doctor
Thank you! 😊
@@seattlefacialDo you do open and closed for bulbous tips? I just had a consultation elsewhere today and they said for my bulbous/boxy tip that has started to droop that I need open rhinoplasty. He said closed won't allow a surgeon the see enough of what's going on with my cartilage.
Its this type of thinking is why everyone is going to Turkey. I was told that because of my age and my thick skin i wasn't a candidate. I went to Turkey and Dr. Bora literally changed my life. Also here in the United States the price was around 15,000 in Turkey it was 8,000 including the airfare.
Looks great. 😍 I wish I didn’t live on the other side of the country.
I wish I didn’t live on the other side of the world
I am an asian man with wide nose tip. I would like to get it narrowed with this same procedure. Can I have a consultation?
Nice video
along with a nice nose, she now has a great jawline too. Was this just weight loss, or was there work done on her lower face too? She looks great
The example person has a nose similar to mine, but my nostrils are much larger. Can the nostrils be reduced in size? Not narrowed, but the total nostril size made smaller?
How do you know whether it is thick skin or not
Damn I have this and I was thinking of a nose job and now I can’t since I have thick skin. Hopes and dreams gone.
Is this different to tipoplasty? I’ve watched a heap of videos of tipoplasty and it’s way simpler than this video… is this a different process?
I’m sos sad cause I had a nose job done to have a flatter nose bridge and my surgeon made my nose bridge lower but the point is super high which I hate, do you know if theres any non surgical way to fix that ??
Not sure why you didn't mention defatting the nasal tip which is done.
How to know if its cartilage and not thick skin? If it is thick skin what would be the best procedure done?
Touch the tip you can feel the cartilage
if in my case i have thick skin, want kinda of procedure/surgery i can do it to reduce a bulbous nasal tip? btw great video doctor
If you are African American then you should go to a doctor who knows how to work with thick skin. This doctor clearly does not because he made it seem like you can’t get your nose reduced if your skin is thick and that is not true. He just doesn’t know how to work with thick skin.
I had my bump removed on my nose and a reduction of the nasal tip and 20 years ago. Now, I think I have a slight nasal bone break that, for a short time pierced the skin and left a small amount of blood. Now it has healed, but I have a discoloration (about 1/2" long) where the piercing had occurred. It concerns me.
why did it break ?
I just realized why I have that break. An ophthalmologist removed a cyst over my eye and I keep saying "he's breaking my nose." And he did. The break resulted in a slight bit that came up and pierced the skin. It's healed now but took a long time.
@@drpat22 omg , did you sue him ?
How can a person tell if they have thick skin or not?
Do you guys have experience with ethnic/African American noses?
Hi doctor, is it possible to do tiplasty using close rhino? or only open rhinoplasty?
both
What if your nose is still swollen after 2 years could you still tape,?
How much is this?
How can I tell if it’s just thick skin?
Sir I have narrow nose but I want wide or bulbous shape nose..is it surgery possible?
How much cost pls
1 week ago my friend pulled my nose tip..
Now my nose tip looks little longer..
Will my nose get back to normal size? Pls reply
Doctor your nose pretty
hi dr., im just wondering - i have kind of a bulbous nasal tip that im conscious about. it’s nothing too bad but its still a concern; it’s the only thing im unhappy with regarding my face/nose. the sutures you mentioned interest me - do you know if sutures to define a nose tip can be done without having a full-blown surgery/removal of cartilage? thank you!
Yes, I believe this procedure is called a tipoplasty it could be done on bulbous noses or to adjust or thin the nasal tip without breaking the bone. It's not a very invasive surgery compared to rhinoplasty, but it could be difficult to find a place that performs this procedure depending on your area.
Edit: I'm not the doctor but I have seen this procedure done on others I know and would like to have it done on myself
@@lillianharp1365that’s what i was recommended. A tip plasty and alar reduction. Western Canada isn’t the best for plastic surgery. Not a lot of options and the most popular one that’s advertised everywhere was horrible in the consultation. Basically told me it’s pointless to even try to change my nose because I won’t have a small nose. I never asked for a small nose, i just wanted a less bulbous nose. I went to another surgeon who recommended a tip plasty and alar reduction, but also ignored my emails when i asked for more information. I went to the consult for a lip lift and he told me not to do it because it would make my nose look bigger (i had it done at another clinic and it didn’t make my nose look bigger and my face looks better proportioned).
Most plastic surgeons here seem to brush people off if they are not attractive enough or rich enough. I had almost enough saved for the tip plasty and alar reduction, but they brushed me off.
That’s off topic.
But, i agree, some areas just really are not good for plastic surgery. If i could drive and there wasn’t a pandemic, i would consider going to the US. They seem to have so many good surgeons, and a lot more variety.
Where is the spreader graft cartilage taken from in her case?
In that case alar base reduction is not necessary to narrow the bulbous tip??
No its not , just to narrow the bridge
I want to keep my nose shape I just want a smaller nose tip :(
Why can't u shave thick skin down to make it thinner ??
bc it’s skin and not a bone.
@@fulltimeleo skin doesn't have a vein Have u ever ate chicken before ? the skin can be PULLED and CUT that's no excuse!!they can thin the skin dwn They are doctors they create solutions it probably will cost more but ppl won't mind paying if it's sum they want
Hello doctor i had a rhinoplasty one week ago and my nose tip looks so piggy I can’t stop crying what should i do?
It’s been a week. You’re not going to see results yet.
Do you feel any better about it?
You cannot even begin to make judgement calls until you are at least three months post op. You are extremely swollen and will still be swollen for the next several months following your procedure. You should definitely contact your original surgeon with questions/ concerns.
Which country?
It been 6months of my surgery,but there is rigidness and puffiness on nose tip ,dr. Said it is due to graft that he putted in my nose tip for septoplasty but it is 6months now and my nose still look swelled😔
Bro my nose also till.swollen
I think it's infection
I have almost the same nose and it gets worse as i get older. Worse is its assymetrical with a visible dent on the top of my bulbous tip.
I am in my 40s and still toy with the idea. I just cant afford it alomg with all other issues i have with aging. It sucks.
I know the feeling. My nose looks similar (but worse), i was quoted $14k for a tip plasty and alar reduction. I just spent $7k on lip lift and one gliding brow lift (they were uneven).
I also want chin lipo and blepharoplasty, and a forehead reduction.
My skin isn’t that loose yet for a facelift, i use retinol and HA5 (Skinmedica, my favourite skincare brand). And I avoid the sun and wear sunscreen. And eat a lot of fruit. And take vitamin d and c everyday.
I ate so terribly over the holidays and my skin is showing it. But i will eat better in the new year.
I have a long bulbous nose with vertical dent. When I smile it is ugly. Is there any help you can give me? I have no money for this type of surgery. Can I send a picture?I know my nose keeps me from having a man in my life. Please help if you can. I have been told my whole life that I am ugly when I smile.😞
I'm having the same exact problem. No $, less attractive when I smile, most men feel my nose is a deal breaker and I feel God doesn't make mistakes but I want happiness in this lifetime and I want to take pictures often without looking at a nose that spreads.
@@latishiabedwards1423 yeah it sucks. We are all beautiful in our own way but it is hard when you have this kind of problem. Peace.🌞
No offence but why would this dr who doesn't even know you help you out if you don't have any money ? Just curious.. I guess you never know unless you ask though so good for you.
Dr., can this be performed under local anesthetic versus general?
You really don't want to be awake while they're carving at your face.
I have the ugliest nose in school people called me a pig so I hate my nose
i always that my nose was bad noo it’s my tip!
Everything about my nose is big bruh i have the curvy thick down tip, wide nose bone on the sides and big long nostirls
you a straight n199a
Un sure these pictures are after and before as in the good nose is before..
How much does this kind of surgery that requires more work cost?
All rhinoplasties are one set price unless you have already had a previous one in which your case becomes more complex. You can find all pricing on our website at seattlefacial.com.
What is suture ?
a stich or stiches used to close up wounds/incisions
Can people like myself still get a rhinoplasty surgery during COVID-19?
😓
Can this procedure be done by 14 year olds?
🌿☘
So steroid injections for thickened skin
i need money
I need u