About Tip Plasty as part of Rhinoplasty:
I have been doing Rhinoplasty for over 35 years and what’s required to fix a wide bulbous tip depends on several factors including the angle of tip rotation, if the tip cartilage is asymmetric or weak and whether the skin is thin or thick. The tip cartilages will be typically trimmed and possibly sewn together. A cartilage graft can be added if additional tip support is required or the skin is very thick.
When dealing with a bulbous tip usually a combination of surgical maneuvers are indicated. One must debulk the soft tissue calle defattening, trim the lower lateral cartilage, remove interalar tissue, suture the lower lateral cartilages together to refine and define the tip. Removing tissue from the tip of the nose for a bulbous tip is actually a risky maneuver. This can devascularize the tip and lead to skin death at the tip of the nose.
