As we discuss in the past, primary and revision rhinoplasty is the most challenging and detailed procedures in cosmetic surgery. Not all plastic surgeons can offer rhinoplasty of any nature and many don’t. The first time is the best time to achieve an optimal result. Avoid a revision surgery unless absolutely necessary.
The tip of the nose is anatomically made of skin, the underlying or subdermal tissue, cartilage, and its connecting anatomic structures mostly cartilage. There is no bone in the tip of the nose.
Bulbousness or the lack of refinement of the tip is usually due to excessively thick dermal tissue. In the dermis are blood vessels, glands, and possibly small hair follicles. These elements combine in some individuals to prevent or work against an elegant nose. So, in my opinion the answer is no. There is no easy fix for a bulbous tip. Especially as an office procedure. There are some special techniques that can be done to give the bulbous tip better structure and refinement.
Bulbous Tip Rhinoplasty
If there are irregularities either congenital or traumatic, oftentimes a filler may be put to use to improve the contour and fill out the “dent” or depression in the nose. I prefer unequivocally the closed technique. Therefore, all work can be done through incisions inside the nose.
This technique in my opinion offers better control analysis and restructuring in comparison to the open technique. A technique that cuts across the tissue between the nostrils. There are multiple procedures that require the use of tools that penetrate the skin. Fortunately, in almost all instances the skin of the face and nose are very forgiving in these areas of entry. They heal with very little evidence of surgery or visibility.
In summary, I prefer the close technique. The incisions are internal unless nostril adjustment is necessary. In this case, incisions may be a requirement in the groove where the nostril rim joins the cheek. This area is usually in the shadow. In any incision here, it is usually imperceptible. However, there are some instances where makeup and concealer may be necessary.