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Nasal Tip

The tip is one of the most important aesthetic parts of your nose. In the middle of your face, it often defines the nose and sometimes the whole look of the face. If the tip is well proportioned and defined we don't notice it, as it blends so well with the other features that we focus on the individual's eyes.

But if the tip seems rounded, bulbous, or disproportionately large, it can distract from the eyes and make the nose seem undefined. While the tip is a frequent concern of San Francisco and Oakland rhinoplasty patients, it is also one of the most difficult areas to improve. It is particularly challenging to get a great result from the front, which is why you may notice that many before and after views from other surgeons show the profile or 3/4 views but not the frontal view.

There are several common complaints about the nasal tip including bulbous undefined tips, large tips, boxy or bifid tips, asymmetric tips, droopy and/or mobile tips. This page will give examples of before and after rhinoplasty images of patients with these nasal tip concerns. Request a consultation online or call us at (415) 445-9513 today.

Featured Cases

Case 319

Background: This Bay Area woman, in her 30's, felt she was looking older and wanted to freshen up her look. She consulted with Dr. Mabrie about Dermafillers for her under eyes. Dr. Mabrie's Assessment: "I am really excited about this case. Pretty often I see some moderate sagging of the cheek skin. I also noticed that her nose had some asymmetry to it and I felt it would really make her face look...

Case 318

Background: Woman with Eastern European background, living in the San Francisco Bay Area, had received Juvederm previously for under eye circles but wasn't happy with the outcome. She found Dr. Mabrie online and was impressed with the patient reviews. She was also impressed with Dr. Mabrie's approach and focus on non-surgical facial sculpting. She consulted with Dr. Mabrie for treatment of he...

Case 312

Background: This woman in her 40's and mother of 2 had been considering treatment for her nose about a year. She found Dr. Mabrie online and liked the reviews and photo gallery examples. She decided to schedule a consultation in his San Francisco office. Dr. Mabrie's Assessment: "This patient was an excellent candidate for Non-Surgical Rhinoplasty. On frontal view, the contour of her nasal bridge...

Case 305

ABOUT OUR PATIENT This woman from Santa Cruz really liked the way her face looked in general but was interested in refining her nose. She felt it was a little round and slightly bulbous in appearance. Evan so, she knew she definitely did not want an invasive surgical procedure to fix it. When she found my website, watched our videos, and reviewed the before and after photographs, she decided to v...

Case 300

Background: This African American man in his 20's, had long felt his nose detracted from the rest of his face. While he liked its shape in general, he felt his nose looked too childlike. He searched for a surgeon familiar with ethnic rhinoplasty. He liked Dr. Mabrie's videos and consulted with him in his San Francisco office about Non-Surgical Rhinoplasty.   Dr. Mabrie's Assessment: In th...

Case 276

Background: This young woman from the East bay wanted to subtly change the look of her nose but was not wanting surgery. She consulted with Dr. Mabrie at his San Francisco office about Non Surgical Rhinoplasty. Dr. Mabrie's Assessment: "This case illustrates the importance of a smooth nasal contour. With Rhinoplasty surgery her nose would been reduced, breaking the bone and cutting the cartilage....

Case 261

ABOUT OUR PATIENT I love this case! This woman in her 70s from the East Bay, had long considered getting surgery to narrow her nostrils. She and I had a great talk during a consultation in my San Francisco office regarding Surgical Rhinoplasty, in which we explored options that would get her the amazing results she was after. DR. MABRIE'S TREATMENT PLAN I performed a Non-Surgical Rhinoplasty us...

Case 218

ABOUT OUR PATIENT This young lady was already feeling somewhat satisfied with the shaping of her nose, but she knew there was room for improvement. She felt it looked a little round and slightly undefined. Basically, she was looking for a change that was defining but not too drastic. After searching online for a facial plastic surgeon specializing in Non-Surgical Rhinoplasty, she found our before...

Case 210

ABOUT OUR PATIENT This patient initially visited my San Francisco office interested in finding the right kind of filler treatment for bags under her eyes. I noticed her nose was somewhat misshapen and injured as well. She told me it was the result of a Rhinoplasty she had many years ago. There has been a hump reduction during the Rhinoplasty surgery, which had caused the middle cartilaginous port...

Case 208

Background: This young San Francisco woman was interested in Rhinoplasty surgery.  She chose Dr. Mabrie because of his experience with preserving ethnic characteristics and maintaining natural results.  She wanted a softer nose, like her mother's, with better symmetry, a smaller tip, and a straighter profile.  Lastly, when she smiled and said certain words, like, "no", her nasal tip...

Case 201

Background: This woman had long considered Rhinoplasty surgery. Her nasal tip was full and similar in size and shape to the nose of her father. While she liked his nose on him, she wanted something softer and more feminine. After searching several plastic surgery websites of doctors in San Francisco, she found Dr. Mabrie and scheduled a consultation. Dr. Mabrie's Assessment: "This African America...

Case 195

Background: This young woman had a previous Rhinoplasty years ago that had given good results. Years later she started to see a change in those results. She came in to see Dr. Mabrie for a consult with specific goals in mind. 1. Narrow the nasal bridge. 2. Make the tip less round. 3. Smooth the contour of her nose. 4. Improve her profile. Dr. Mabrie’s Assessment: "After her initial Rh...

Case 169

Background: This 24 year old African American woman consulted with Dr. Mabrie about Rhinoplasty in San Francisco to improve the appearance of her nose. She explained that she would like the bridge thinner and tip more detained to match her face. Dr. Mabrie's Assessment: "The nose actually has a nice size and shape to start. There is a small bump on profile and the tip could use some definition. T...

Case 120

Background: This 21 year old Tourism student is of Spanish and Italian ethnic background. She had a history of trauma a few years ago during a water polo incident.  Her concerns were to: 1. Primarily reduce the bump in her nasal dorsum, 2. Resolve her difficulty in breathing, 3. To smooth the lines in her nose, and 4. To maintain the look and character of her nose. Dr Mabrie&...

Case 94

Background: This Filipina woman in her 20’s consulted with Dr. Mabrie in his San Francisco office, interested in a Rhinoplasty. She had been asked to do some modeling and noticed that on certain angles her nose was less defined than she would like. Her husband, who felt she was beautiful as was, supported her wish to obtain a consultation but urged her not to get “that o...

Case 67

Background:  This Bay Area woman was very active in outdoor activities and did a lot to keep herself in good physical condition.  She liked her all the characteristics of her nose except that when she smiled, in photos, the nostrils appeared somewhat wider than she liked.  She consulted with Dr. Mabrie about surgical options and cosmetic rhinoplasty in San Francisco.Dr. Mabrie's Ass...

See All Before & After Photos

Asymmetric Tips

The tip shape is created by the underlying cartilages and the way they interact with the skin. Asymmetric tips occur when the shape of the two cartilages differs from the way the cartilages are positioned on the septum. Correcting an asymmetric tip may involve modifying the shape or position of the underlying cartilages.

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Bulbous/ Undefined Tips

There are several reasons a nasal tip may seem broad, bulbous, or undefined, including the size or shape of the cartilages, the space between the two cartilages, or the firmness or softness of the cartilages. If the skin is thin to normal, the most common cause for a bulbous tip is the shape and size of the cartilages. There are two nasal cartilages which are c-shaped. At the apex, these cartilages press against the skin and form tip-defining points. Together the two tip-defining points constitute the tip. If the cartilages are far apart, the tip defining points are far and may make the nose appear broad, bifurcated or boxy.

If the cartilages are very soft and the skin is thick, the tip defining point may be hard to see, making the tip bulbous and large. In many of these cases the cartilages are brought together, but additionally a tip graft must be used to press against the skin and create a defined tip.

Drooping Tips

In general we prefer for nasal tips to point straight forward. It is less desirable for tips to appear rounded or to point downward from the profile view. Drooping tips are treated by strengthening the nasal cartilages, either using a strut graft or attaching the cartilages to the nasal septum.

Non-Surgical Treatment of the Nasal Tip

The nasal tip appearance may be altered non-surgically using dermafillers placed under the skin. Dermafillers are synthetically engineered FDA approved substances which are well accepted by the body. They last for 6-12 months, gradually turning into water and CO2 until they are completely absorbed by the body. Some dermafillers may be reversed by injection of another material.

Tip definition and tip asymmetry may be treated with injection of dermafillers.

While dermafillers may be FDA approved for use in the face and may be helpful for contouring in the nose, non-surgical rhinoplasty is not one of the FDA indications and is classified as an off-label use. There is a risk for infection and tissue injury. Dermafillers must be used carefully and preferably by a professional with a great deal of experience with either rhinoplasty surgery or dermafilller injection. Dr. Mabrie is certified both by the board of Facial Plastic Surgery and the board of Head and Neck Surgery. He performs aesthetic procedures exclusively on the face.

Pitfalls in Tip Surgery

Two of the methods used to modify nasal tip size and shape are reducing the size of the cartilages or suturing the domes together. While these methods are very effective, they can also result in an operated on or unnatural appearance after some rhinoplasties.

When reducing the cartilages, it is very important to preserve enough of the tip cartilages to support the overlying skin for many years after the surgery, even as scar tissue develops.

Sewing the cartilages together is a method which is particularly useful in boxy or bifurcated tips. If overdone, however, this technique can cause collapse of the cartilages and create a pinched appearance. Sometimes, instead of sewing the cartilages too close together, it's preferable to use grafts and sutures to change the shape of the cartilages, thereby avoiding collapse and the pinched look.

San Francisco Facial Plastic Surgeon David C. Mabrie M.D., F.A.C.S.

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David C. Mabrie, M.D.
166 Geary Street #1502
San Francisco, CA 94108
(415) 445-9513
Dr. David Mabrie
1700 San Pablo Avenue Suite F
Pinole, CA 94564
(510) 724-3200