As you might imagine, if this portion of the lower lateral cartilage is excessively prominent, it can contribute to a wider, more bulbous looking nose. In the adjacent photo diagram the arrows are pointing to the cephalic margin of the lower lateral cartilage. The cephalic portion of the lower lateral cartilage refers to the upper edge, or margin, of the cartilage (the side that is opposite the nostril rim) when looking directly at the nose from the frontal view. You can really appreciate this change on his oblique view, which truly highlights the amount of bulbosity in his nasal tip.Īn alternative rhinoplasty technique is to perform what is called a cephalic trim maneuver. In doing so, I was able to significantly reduce the prominent arch along the nasal tip and provide him a more refined nasal tip appearance. In this male rhinoplasty patient from San Diego, I reduced the bulbosity of his tip with careful placement of permanent sutures within the lower lateral cartilage on both sides. The photo below is an example of the suture technique to reshape a bulbous, rounded nasal tip. These are called dome-binding sutures and can be very effective at narrowing the tip and providing significant improvement in nasal tip definition. The pair of cartilages are then brought closer together at the same time. Permanent sutures can be placed through the dome region referenced above to narrow the lower lateral cartilage on each side. In some rhinoplasty cases this is accomplished readily with suture techniques. Rhinoplasty to correct a bulbous, rounded nasal tip is directed at reshaping the lower lateral cartilage to approximate more of a soft triangular appearance. Management Of The Bulbous, Rounded Nasal Tip In the bulbous nose, the tip is much wider than the nasal bridge. If you remember from our online rhinoplasty tutorial nasal analysis page, the nasal tip should be just slightly wider than the upper bridge. Some people would say it simply does not have much definition. It looks excessively large for her nose and is more rounded in shape.
If you look at this patient’s frontal view, one of the first things you notice about her nose is the nasal tip region. So what does a bulbous, rounded nasal tip look like in the typical rhinoplasty patient? The attached patient photo is a great example of a bulbous, rounded nasal tip.
If you compare the normal nasal tip cartilage with the bulbous tip cartilage you can see an obvious difference in terms of width. A bulbous nasal tip results when the domal cartilage is excessively wide and rounded (as shown below middle and right). If the dome cartilage is appropriately oriented (as shown below left) the nasal tip will approximate the desired soft triangular shape. The point at which the two cartilages diverge away from one another is called the dome region and significantly impacts the shape of the nasal tip. They then diverge from one another to form the structural support of the nostril rim on each side. The two lower lateral cartilages merge in the midline to help form the support of the nasal tip. The lower lateral cartilages are shaded red and are typically fairly similar in shape and size. The lower lateral cartilages refer to a pair of cartilage structures as depicted in the adjacent diagram. What Causes A Bulbous, Rounded Nasal Tip?Ī bulbous, round nasal tip is a direct result of the shape of the lower lateral cartilages. We call this a soft triangle, which means it gently slopes in a convex orientation from the midline out to the sides.
Overall, the nasal tip should be triangular shaped as seen from below, but without any sharp angles. It should be proportional in terms of size and width such that the bridge gently blends or transitions into the nasal tip. In short, the nasal tip should simply not draw attention to it. To gain a thorough understanding of what the ideal nasal tip shape should be, refer to our rhinoplasty tutorial section on nasal analysis. Others describe the nose as being poorly defined without shape. Most rhinoplasty patients with a bulbous nasal tip describe their nose as being too wide or too big. A bulbous nasal tip is one that simply looks more rounded – almost like a ball positioned on the end of the nose. The bulbous or rounded nasal tip is one of the more common reasons that patients seek rhinoplasty, or nasal reshaping, surgery.
0 kommentar(er)
