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In the previous chapters of this blog (click to read part 1click to read part 2) we told you about cosmetic and functional rhinoplasty, describing the reasons for some procedures and the procedures themselves. In this last part we will describe a few more conditions and the rhinoplasty procedures that are used to correct them.

Nasal Tip Rhinoplasty

Tip rhinoplasty procedures are performed with the aim of altering the nasal tip. Some patients may complain that their nasal tip is bulbous, too wide, too narrow, or boxy. Tip rhinoplasty can be used to add definition to a weak nasal tip or refine a nasal tip that is too prominent. The nasal tip can be also set too high/low or twisted upward or downward in which case rhinoplasty can be used to adjust the angle or height of the tip.

Depending on the specific individual concern of the patient, the tip rhinoplasty surgery can be anywhere between a simple, quick procedure meant to achieve a subtle alteration in the appearance of the nose, or a very complex process that will take hours. In this type of surgery any of a variety of techniques can be used, some of which are sculpting, suture application, and use of grafts. In cases when grafts are used, they can often be made from the patient’s own cartilage. This is harvested from the nasal septum, ear or even the ribs. It takes some people aback, but the truth is that it is the most natural way to go about it, and the best way to ensure optimal healing.

Correction Surgery for Alar Retraction and Hanging Columella

Alar retraction is a condition when a specific portion of the nose near the tip (known as the ala) is strongly turned upward. The result is excessive nostril show and some possible obstruction of breathing. This may be congenital or caused by damage during previous surgery. One way or another, it can be corrected using cartilage repositioning, composite grafting, or alar rim grafts.

The columella is the thin portion of skin at the base of the nose that separates the nostrils and connects to the upper lip. Sometimes, when too much of the columella is visible because of it protruding downward (a condition that is known as a hanging columella). A hanging columella will also result in more of the nostril showing, it is different from alar retraction and is therefore treated differently.

A hanging columella is also accompanied by a droopy tip, a short upper lip, a long lateral cruse, and some other deformations. It is a condition that may be congenital or it may be a result of poorly performed rhinoplasty.

Correcting this condition may require excision of excess septum tissue that may be the source of the protrusion. If it is caused by grafts left over from previous surgery, then revision rhinoplasty can be performed in order to extricate or reshape the grafts.

Following this and many other surgical procedures, and as a means to secure recovery, a splint will be placed on the nose. The splint and dressings that were applied then will normally be removed after six to seven days after surgery. If nasal packing had to be used after surgery, it will be removed on the next morning unless the surgeon has reason to decide otherwise. Some discomfort, bruising and swelling is normal after any procedure and should be expected. Those symptoms can be helped with over the counter pain medication. Bruising is also common around the eye and nose area and may persist for a period of approximately ten days. Swelling will take a bit longer to dissipate, sometimes lingering for a month or more. Patients are often able to return to work after one week but hard physical exercise is strictly advised against for a period of six months or more, depending on the progress of the recovery.

Finesse Rhinoplasty

Some rhinoplasty procedures may not involve or require any major changes. Many patients don’t have major problems with their appearance and are merely seeking subtle changes to the shape of their nose. This is when finesse rhinoplasty is exactly what you need.

Finesse rhinoplasty only involves the very minimum of very specific alterations which are introduced to “fine tune” the appearance of the nose while conserving all other features of the nose and face.

This can be a particularly attractive solution for models, actors and public personas, who do not want to disappear for long recovery periods or have a very noticeable or obvious change that wills spark rumors and gossip. Finesse rhinoplasty is normally only performed using local anesthesia in closed rhinoplasty technique.

Remember, while the changes that the finesse rhinoplasty introduces may be very subtle, this procedure still does require a very skilled and meticulous surgeon, especially for ethnic patients. We hope you enjoyed this – stay tuned, or send us an email with any question that you have or want us to cover in the next blog releases.


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    I am a 27 year old, African-American female from the Midwest and I just recently had a Rhinoplasty procedure performed on February 9, 2012. I had known for a long time that I wanted to have the procedure done to correct a bump in the bridge of my nose, reduce the width of my nose, as well as to refine my down-turned nasal tip. This was an operation that I was not going to trust to just anybody, so I spent countless hours researching and looking for a surgeon who had significant experience working with African-American patients. Because I liv...
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