Large or bulbous nasal tip

What a large bulbous nasal tip is

A large bulbous nasal tip is a tip that looks rounded or disproportionately large for the rest of the nose, often with little definition between the tip and the bridge.

It may show some of the following:

• Excess soft tissue. The tip looks rounded and large compared with the rest of the nose.
• Lack of definition. There is little refinement along the tip, with poor separation between the tip and the bridge.
• A drooping or downturned tip. In some noses the tip also hangs low, which adds to the bulbous look.

What I examine for is the cause, because the cause decides whether an operation would change anything and what it would involve. My assessment is of the cartilage, the skin thickness and the support beneath the tip, and the plan follows from what I find.

What causes it

• Genetics. Nasal shape and structure are largely inherited. A family history of a large or bulbous tip is common.
• Ageing. Changes in the skin and in the support beneath the tip can lead to drooping or enlargement of the tip over time.
• Trauma or injury. A previous fracture or injury, including one in childhood, can alter the anatomy of the tip.
• Cartilage weakness or malformation. Weak or misshapen lower lateral cartilages, which form the tip, can lead to poor definition and a bulbous look.

Treatment options

• Rhinoplasty. Rhinoplasty changes the size, shape and projection of the tip. How much it can change depends on the thickness of the skin and the strength of the cartilage. Techniques include tip refinement, cartilage reshaping and tip rotation.
• Cartilage grafting. Where the tip lacks support because the cartilage is weak or out of position, grafts can be used to strengthen it and improve its shape and projection.
• Revision rhinoplasty. If you have had rhinoplasty before and are unhappy with the tip, revision surgery may be an option, and it is assessed in the same way.
• Filler or injectables. I do not use filler or injectable treatments in the nose. My adult practice is surgery of the nose only.

A bulbous tip is one of the commonest things people ask me about, and one of the harder things to change predictably, particularly where the skin is thick.

What I do not offer

I do not offer surgery to everyone who consults me. I will tell you what I think is achievable for your tip and what is not. If the change would be too small to be worth the recovery, that is what you will hear.

Recovery

Most bruising settles in two to three weeks and most visible swelling over six to eight weeks, and swelling can briefly increase again at around four to six weeks. Most people take 10 days to two weeks off work. The tip is the slowest part of the nose to settle, and the final shape is not settled for about twelve months. No technique shortens that.

Next step

The operation itself is described on my rhinoplasty page. Consultations are at Indooroopilly, Springfield and Ipswich, and the first consultation can be done by video for patients travelling from outside Brisbane, although meeting in person is ideal. Send an enquiry and we will reply within one business day.