Surgery for the Bulbous Nasal Tip

Correction of the bulbous nasal tip is difficult. Numerous techniques for tip rhinoplasty have been described, but many differ in their treatment of the wide intercrural angle and the flared lateral crus, which are characteristics of the bulbous tip. The technique described in this article has been used successfully on 44 patients over the last two years. The technique is as follows: if the skin is thick and there is adequate projection of the tip, the rim should be transected just lateral to the genu. If there is too much projection, a piece of the rim should be removed. If the skin is thick and there is adequate projection of the nose but a bulbous appearance because of the flared arch, a portion of the arch should be resected without removal of the lining. If there is unilateral or asymmetrical deformity, the individual segments can be resected.