A Nose with a Bulbous Tip
The term bulbous tip relates to the lower third of the nose being described as excessively round, bulging and/or fat. This is due to the large size of the lower lateral cartilages and exacerbated by thick nasal skin.
Improvement can be made by reshaping the lower lateral cartilages but care has to be taken to ensure excessive cartilage is not removed as this can result in weakness of the side walls (giving rise to secondary problems of nasal blockage) and scar tissue formation causing knuckles to occur (bossa formation).
A number of methods are used to improve the shape of the nasal tip. Such techniques include reducing size of the lower lateral cartilages and use of suture techniques to change the shape of these cartilages. Newer techniques include utilising thin strips of cartilage (lateral crural strut graft) which are placed underneath the curved lower lateral cartilages and by suturing the two together the excessive curvature of the bulbous tip can be refined. Please see before and after sections for examples.