Nose Tip Refinement with Miami Plastic Surgeon, Dr. Bared
Tip refinement in rhinoplasty is the aspect of rhinoplasty where the attainment of natural results is most imperative. As a rhinoplasty specialist, he often sees poorly performed tip refinement in his revision rhinoplasty cases performed elsewhere. In revision rhinoplasty, Dr. Bared has noted that the largest complaint he sees from patients who have had previous surgery performed elsewhere is that their tip appears unnatural and pinched. Patients complain that while they may, at first, have been pleased with the appearance of their tip, they noticed that over time their tip started to take on a more unnatural appearance. Dr. Bared’s main objective in rhinoplasty surgery is for aesthetic refinement of the nose with natural-appearing results. The attainment of natural appearing results has come from his intense analysis of the nose and careful attention to the natural configuration of the nasal tip cartilages. Dr. Bared does not achieve tip refinement by the over aggressive removal of cartilage, but rather the re-orientation of the cartilage through suturing techniques and the precise removal of cartilage in certain areas.
Dr. Bared feels that close attention needs to be given to the orientation of the cartilages of the nose as much as the size of the cartilages. The inexperienced rhinoplasty surgeon notes the size of the cartilages contributing to the shape of the tip and does not pay attention to the orientation of the cartilages. However, it is BOTH the size and the orientation of the cartilages which give the tip its shape. The inexperienced surgeon may therefore aggressively remove cartilage from the tip to try and achieve a more refined tip shape not minding the orientation of the cartilages. The over aggressive removal of the nasal tip cartilages can lead to issues after surgery. As the skin overlying the cartilages heals, it ‘shrink-wraps’ over the cartilages. If the cartilages lose their inherent strength, this could lead to undesired results in the long term. In lieu of removing too much of the tip cartilages, Dr. Bared uses sutures and re-orients the cartilages if warranted. Special attention is paid to the thickness of the skin overlying the tip cartilages as this also steers the approach taken. You can read more about Dr. Bared’s approach to the different degrees of skin thickness in the section about skin thickness.
Dr. Bared’s practice consists largely of Rhinoplasty Procedure – 70%
The nasal tip needs to be assessed as a three-dimensional structure. Refinement of the tip is most evident on the front view of the nose (the most important view). The inexperienced surgeon may too often be focused on the profile of the nose and they neglect the frontal view. However, it is the frontal view of the nose where most refinements need to be made to create an aesthetically pleasing tip and natural-appearing tip. The goal of tip refinement in rhinoplasty is the attainment of an aesthetic tip shape with natural appearing results. The unnatural appearance of the tip is a telltale sign of a rhinoplasty. Therefore, it is the proper and detailed understanding of the anatomy of the tip and the execution of techniques which provide for great results in tip refinement surgery.