Address an Overly Narrow Look in the New York Area
A pinched nose tip is the common term for when the lowest part of the nose is very narrow, creating an aesthetically unpleasing appearance to the nose. Ideally, the nose on a man or a woman should maintain the same width from top to bottom, with the width of the nose diverging slightly to the area plastic surgeons refer to as tip-defining points. In essence, we are referring to a very narrow tip. For a pinched nose tip, New York-area rhinoplasty patients will find that there are several potential causes, but a main potential solution.
The first cause of a pinched nose tip is congenital—the medical term that refers to how someone is born. Some people are just born with a very narrow tip to their nose. Many of these people have difficulty breathing,though some do not. Another cause of a pinched nose tip can be trauma. Over the years, we have seen patients who have fractured the lower cartilage of the nose in a way that has resulted in collapse or a very narrow tip. Perhaps the most common cause of a pinched nose tip that is not related to birth is poorly performed rhinoplasty surgery. Surgery with an inexperienced surgeon can result in the removal of too much cartilage in the tip of the nose in an attempt to achieve a more refined tip. With time, aging, and scar contracture (this is referred to the “shrink wrap effect”), the lower aspect of the nose can actually appear very narrow or pinched. A somewhat unflattering term for this is “pencil tip.”
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Correcting the pinched nose tip in most individuals starts with obtaining a consultation with an experienced rhinoplasty specialist who will evaluate the inside and outside of the nose to determine the causes and a plan for fixing the pinched nose tip. Many times this will require harvesting cartilage from either the septum or ear to help rebuild the tip of the nose so that it is much more balanced and in alignment with the nose from top to bottom. Before discussing this specific plan, many reputable surgeons will include computerized imaging so that they are able to effectively communicate with the patient to obtain a desirable and achievable goal.
Pinched Nasal Tip FAQs
Where Are the Incisions in Pinched Nose Tip Surgery?
Whether incisions used for pinched nose tip surgery are visible or not depends on the approach used: open or closed. The closed approach is often referred to as endonasal or “scarless,” as incisions are internal, and therefore not visible.
Despite this, some surgeons still prefer the open approach, believing they have a better view and can thereby perform the surgery more precisely. However, experienced surgeons like Dr. Edwin Williams often prefer the endonasal or closed approach when correcting a pinched nose tip for its more reliable outcomes and reduced scarring, discomfort, and healing time.
The closed approach is a more complicated surgery, requiring a surgeon who has developed the skill and knowledge to expertly perform endonasal procedures—such as Dr. Williams, who spent years perfecting his skills via the open approach.
The pinched nose tip procedure is covered in more detail in the doctor’s Famous Fireside Chats series titled The Great Debate: Open vs. Closed Rhinoplasty.
Do You Pack the Nose After Pinched Nose Tip Surgery?
Unlike some surgeons, Dr. Williams avoids packing the nose with substantial dressing, which can be the most distressing part of pinched nose tip surgery. His experience shows there is no need for a lot of packing, especially when opting for the endonasal or scarless approach he favors.
Dr. Williams has found that heavy packing does not hold the nose in place postoperatively and, when the pinched tip procedure is performed properly, packing does little to improve the outcome. He does use a lighter dressing (much like a light-days tampon), removed a day after surgery.
At the time of the removal of the outer splint (approximately one week after surgery), Dr. Williams advises patients to avoid any job duties, exercise, or chores that could bump the nose for up to two weeks. In Dr. his Famous Fireside Chats video, rhinoplasty dressing and removal are demonstrated for pinched nose tip surgery.
Will Pinched Nose Tip Surgery Fix Breathing Problems?
When evaluating a patient seeking to correct a pinched nose tip, Dr. Williams asks about any breathing problems that may be attributable to a deviated nasal septum, incompetent nasal valves, a twisted or crooked nose, or any combination of these.
Patients undergoing pinched nose tip surgery should have this aspect of their anatomy evaluated by an expert surgeon to explore how these issues might be resolved during a cosmetic procedure.
Other related questions are answered in Dr. Williams’ Famous Fireside Chats on correcting and fixing breathing during a pinched nose tip surgery.
The Cost of Pinched Nose Tip Rhinoplasty
There are a number of things to consider when assessing the cost of pinched nose tip surgery. A more experienced surgeon will often charge more for procedures than a less experienced one. Also, geography matters. A surgeon practicing in New York City is likely to charge more for a pinched nose tip surgery than one located in a less metropolitan area, given the difference in the cost of doing business.
Note that a pinched tip revision procedure to address any issues or to refine the results of a prior procedure comes in at a higher cost, as these second or third rhinoplasties are generally more complicated and require additional OR hours.
The cost of pinched nose surgery typically falls between $7,000 and $14,000, depending on factors including operating room fees and anesthesia. Refer to Dr. Williams’ Famous Fireside Chats for other fee considerations regarding pinched nose tip surgery.
Contact Lenses or Glasses Following Pinched Nose Tip Rhinoplasty
Difficulty wearing glasses after pinched nose tip surgery is common, as the splint or cast affixed to the outside of the nose makes it hard to wear them. To get around this issue, Dr. Williams suggests that his patients put a piece of tape around the glasses’ midsection to hang them from the forehead.
After pinched nose tip surgery, he also advises patients to refrain from wearing contact lens until the splint is removed, about one week after surgery.
How is Computerized Imaging Used in Pinched Nose Tip Rhinoplasty?
Prior to pinched tip surgery, the patient’s images are captured digitally and modified by the surgeon to communicate potential outcomes.
Dr. Williams finds computerized imaging to be an extremely helpful patient communication tool and has utilized it for 25 years.
In his book, Rhinoplasty: Everything You Need to Know about Fixing and Reshaping your Nose, Dr. Williams addresses additional questions regarding surgery correcting a pinched tip. He also speaks about such surgery in his YouTube Fireside Chats series on rhinoplasty.
Complications and Risks of Pinched Nose Tip Rhinoplasty
While uncommon, any complications should be fully explained by the surgeon prior to pinched tip surgery. Bleeding or infection, as with any surgical procedure, is possible, though still rare. The surgeon should make patients aware of the fact that about five to 10 percent of pinched nose tip surgery patients will choose to undergo an additional procedure, generally minor and performed in the office. However, when working with a highly competent surgeon, the risk of necessary follow-up surgery is further reduced.
Despite the skill and perfectionistic tendencies of rhinoplasty surgeons, pinched nose tip surgery is not a “perfect” procedure. It requires a balance of the surgeon’s knowledge, experience, and skill, blending them together in a seamless way.
With a full exploration of the procedure and any concerns, the odds a patient will be happy with the results of a pinched tip surgery are much improved.
More information on complications following pinched nose tip surgery is available on Dr. Williams’ Famous Fireside Chats.
Anesthesia in Pinched Nose Tip Rhinoplasty
Many pinched tip surgery patients want to be asleep during this outpatient surgery. This is often the preference of the surgeon as well. This involves local and/or twilight or general anesthesia and is controlled by a credentialed expert anesthesia provider.
Pinched nose tip surgery is further explained in Dr. Williams’ Famous Fireside Chat on Anesthesia for Rhinoplasty.