Board Certifications: American Board of Facial Plastic and
Reconstructive Surgery American Board of Otolaryngology - ABO

Tip Sculpting & Refining

Refining the shape of your nasal tip can have a major impact on the look of your nose, and your face as a whole. Therefore, if you would like to refine the appearance of your nasal tip, it is very important that you choose the right surgeon to perform your rhinoplasty procedure. Patients travel from around the world to undergo tip sculpting and refinement with New York City Facial Plastic Surgeon, Sam Rizk, MD, FACS, as he is an expert in this aspect of nose surgery (rhinoplasty).

If you choose to have your nasal tip resculpted with Dr. Rizk, he will likely use several techniques in combination. The procedure will be individually tailored to fit your unique circumstances.

Read on to learn more about tip sculpting and refining with Dr. Rizk.

Dr. Rizk’s Tip Sculpting & Refining Techniques

Each rhinoplasty patient is unique. Some patients require complex procedures involving numerous rhinoplasty techniques, while others can benefit from minor revisions or even non-surgical treatments. Even a non-surgical nose job with Botox or Dysport can have a significant effect in some patients. However, these treatments cannot be used to make major changes such as reducing the size of a large nasal tip.

Surgical rhinoplasty tip techniques focus primarily on refining the lower lateral cartilages, because they have a major impact on how the nasal tip looks. Generally speaking, tip refinement with Dr. Rizk usually involves removing some of this cartilage, as well as “defatting” and suturing techniques. This combination allows Dr. Rizk to enlarge, reduce, rotate, narrow or otherwise alter the shape of the nasal tip.

Here are some of the more important tip refinement techniques Dr. Rizk is renowned for.


In the hands of an experienced rhinoplasty specialist such as Dr. Rizk, nasal suturing techniques can be a very effective way to safely narrow and refine the nasal tip. Suturing techniques are an excellent way to avoid over-resection of nasal cartilage, which can lead to a “pinched” look in the nasal tip.

Nasal suturing techniques are often used for patients with bulbous nasal tips. Suturing can give the tip a more triangular shape. Typically, permanent sutures are placed in the dome area, often above and below the tip. The lower lateral cartilages are then narrowed, flattened and/or reshaped.

A significant benefit of nasal suturing techniques is that they are sometimes reversible. If you and Dr. Rizk decide that the outcome isn’t perfect, the sutures can often be removed and the nasal tip further refined. In addition, Dr. Rizk’s suturing techniques can leave the nose stronger than it was prior to surgery.


Another technique Dr. Rizk uses in nasal tip refinement procedures is defatting of the skin, along with cartilage fat reduction. These techniques add definition to the nasal tip.

Defatting involves the removal of fat from thick skin in order to make it thinner. To perform the technique, Dr. Rizk uses a high-definition telescope and tiny incisions. Defatting the skin makes other revisions made during rhinoplasty more apparent; if the skin is too thick, it is difficult to see certain structural changes made during nose surgery.

Cartilage defatting involves the removal of a layer of fat from the area above the nasal tip cartilages; these are sometimes called alar cartilage fat pads.

In some cases, Dr. Rizk may perform nostril defatting as well.

Grafting Techniques

Grafting techniques are often used in patients who require additional tip projection and definition. Tip projection is one of the most crucial components of an attractive nose. The noses of people with poor tip projection typically look thick or “heavy.” To achieve good projection, the tip must have proper support. This is where grafting techniques come in, as grafts can provide significant support. Depending on the needs of the individual patient, one or more of several types of grafts may be used during nasal tip refinement, including onlay grafts, umbrella grafts and others.

Nasal grafts are common in ethnic rhinoplasty procedures, because many ethnic rhinoplasty patients have thick skin that leads to poor projection and a bulbous-looking tip. In these procedures, grafts are often used in conjunction with a columellar strut for medial columellar support.

Patients with under-projected tips often need umbrella grafts, which typically are positioned between the medial crura.

Dr. Rizk prefers to use his patients’ own cartilage for grafts used in nasal tip refinement. The cartilage is usually taken from the septum or the ears, although sometimes a synthetic graft called Medpor may be used for definition and support. Dr. Rizk does not use silicone grafts.

To customize his patients’ grafts and create smooth contours, Dr. Rizk often uses delicate dermabrading tools, as opposed to a surgical scalpel.

Tip refinement surgery is almost always a compromise. Many of the techniques used in rhinoplasty can actually weaken tip support. But Dr. Rizk can counteract this effect with grafts, improving tip projection, lessening excess curvature and/or narrowing the nasal tip.

Why Choose Dr. Rizk for Tip Sculpting & Refinement

Rhinoplasty is generally considered the most complicated type of facial plastic surgery, and nasal tip refinement is one of the most difficult aspects of this surgery. Consequently, it is very important that you choose a rhinoplasty surgeon who is an expert in all facets of nose surgery, including nasal tip refinement. Dr. Rizk is a world-renowned facial plastic surgeon specializing in all forms of rhinoplasty. His advanced, customized techniques lead to less swelling, faster recovery and optimal outcomes. As a result, he is well-respected throughout the field of facial plastic surgery.

To learn more about how Dr. Rizk can improve the appearance of your nose, contact our office today.

Written by Dr. Sam Rizk

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