The tip of the nose.

What bothers patients most often

The tip accounts for a large share of requests, because it is seen from the front as well as in profile, and it moves with the expressions of the face. The most frequent reasons:

• a drooping tip, which weighs the profile down;
• a wide or bulbous tip, lacking definition;
• a tip that drops when smiling;
• an asymmetry between the two sides.

A tip is never judged on its own: it is assessed together with the bridge, the lip and the chin. That is the whole point of the simulation carried out during the consultation.

How the tip is reshaped

Three gestures are most often combined:

• a tip refinement plasty, which redraws its contour;
• a reduction of the alar cartilages — the cartilages that shape the tip;
• a support of the tip, so that it keeps its position over time.

The spirit remains that of preservation rhinoplasty: keeping and repositioning the existing cartilage rather than removing it. This is what avoids the pinched, over-rotated look of over-operated tips.

A tip that drops when you smile

This is a frequent complaint, and often badly experienced in photographs. The treatment relies on supporting the tip, with a columellar strut or a septal extension graft: the tip is stabilised, and no longer drops in the same way when you smile.

The case of thick skin

On thick skin, the tip redraws itself more slowly: the skin takes time to re-drape over the new framework, and definition appears gradually, sometimes over 24 to 36 months. Taping supports that period. This particular case is detailed on the thick-skin rhinoplasty page.

Recovery and timing of the result

The procedure is performed in the operating room, under anaesthesia, and lasts on average 2 hours. A splint protects the nose for about a week, and social life resumes after one to two weeks. The profile takes shape quickly; the tip refines more slowly, up to around a year. It is the area that calls for the most patience, and that is normal — the details are in recovery.

Tip and hump: a balance

Lowering a nasal hump changes how the tip is perceived, and the other way round. The two are therefore planned together: it is the final balance, from the front as well as in profile, that decides what is done on each.

Risks and limits

As with any rhinoplasty, there is a risk of asymmetry, irregularity, insufficient or excessive correction, breathing difficulty, or the need for a surgical touch-up. On the tip, the evolution is longer than on the bridge: a result judged too early is never a final result. These points are gone through in consultation, together with the SOFCPRE information sheet (opens in a new window).

Why choose Dr Lange in Montpellier?

A surgeon dedicated exclusively to rhinoplasty in Montpellier, Dr Frédéric Lange treats the tip with preservation and support techniques, for a natural result that lasts. Patients from other regions and countries are seen as part of a rhinoplasty from a distance.