Tip Rhinoplasty for a Bulbous Nose That Fixed a Spread Tip and Crooked Bridge Together — A Case Done Without an Implant

01

What was the condition, and why couldn't height alone improve it?

This patient had a bulbous nose with a spread-looking tip plus a thick, dull bridge line — a case giving an overall stuffy impression. Because simply raising the bridge can't improve this, organizing tip structure to set the center and designing so the bridge and tip connect naturally is important.

Photos also showed a form tilted to one side relative to the bridge. The tip wasn't excessively thick, but a view from below confirmed a structure where the cartilages had spread apart, producing the spread appearance. In this kind of shape, crooked-nose correction and bulbous-nose correction are often considered together.

02

In what order was the surgery designed?

For the spread-looking bulbous tip, the spread cartilages were gathered with tip cartilage tying and a support was built to stabilize the structure, while soft tissue was organized to reduce unnecessary thickness. At the same time, the dull-looking bridge line was adjusted to facial proportions, and balance was struck by considering the columella, the nasolabial angle (the angle between nose and upper lip), and the philtrum line together.

The impression of the tip pulling downward was supplemented by organizing the relevant muscle. Because existing bridge height was reasonable, it proceeded without a separate implant — applying crooked-nose and bulbous-nose correction together in line with a feminine direction. Building a line with your own structure and no implant is covered in more detail in the implant-free rhinoplasty guide.

When structural twisting exists, the internal structure can be affected too — so it's important that crooked-nose correction considers functional aspects together.

03

How did the line change after surgery?

Immediately after surgery — before swelling fully develops — is a point where the formed bridge, tip line, and overall structure can be compared relatively clearly.

• Side line — the nasal line that had looked uneven was organized more smoothly, forming a natural flow that isn't excessive.
• Balance around the mouth — as tip height was organized, the mouth that had looked somewhat protruding changed to a relatively balanced appearance.
• Front midline — with the nose's center set, the facial midline stabilized and the features appeared more defined.

Through this process, the midface volume that had looked sunken regained dimension, and as the stuffy impression of a buried-looking nose eased, the overall facial balance organized naturally. As swelling subsides and tissue stabilizes through recovery, it settles into a softer, more natural form.

04

Summary — a spread tip starts with checking the structure

Bulbous tip rhinoplasty is not simply a matter of raising the bridge — it's a process designed by checking together the spread tip-cartilage structure, the tilted bridge, and soft-tissue thickness. In this case, tip cartilage tying, osteotomy, and muscle organization were combined to refine the line without an implant, and the spread look improved without alar reduction. What's checked in tip correction is covered in more detail in the nasal tip procedure guide.

If you're deliberating over a similar shape, your current nasal structure can be checked directly in a 1:1 video consultation. Actual correction cases can be seen in the before-and-after photos.