How it works
Everything begins with a consultation. Your surgeon looks at the shape of your nose as it is now — whether the bridge is high or low, the tip refined or broad, the skin thick or thin, and whether the nose is short, upturned, humped, or crooked — and then works through with you what you would like to change. Your surgeon also asks about your medical history, allergies, the medicines you take, and whether you smoke, because these affect both safety and results. This is the time for you to ask questions.
Before the day of surgery, you may be asked to have some tests and to stop certain medicines and substances that make bleeding more likely for a set period. The type of anaesthesia depends on how much work is involved and on your own situation; structural rhinoplasty of this kind usually needs general anaesthesia, or local anaesthesia with sedation. Your surgeon will go over the specifics with you before surgery.
During surgery, your surgeon usually makes a small cut across the strip of skin between your nostrils and continues it inside both nostrils — this is called an open approach — to see clearly and rebuild the structure of the tip. Your surgeon places the implant along the bridge to raise it to the height you have agreed on. After that, your surgeon takes a small amount of your own cartilage (usually from the ear or the septum) to build and cover the tip.
Covering the tip with your own cartilage is the heart of this approach: it creates a cushion between the implant and the thin skin at the very tip, which helps the tip look softer and more natural and lowers the chance of the implant pressing against and showing through the skin later. Your surgeon shapes the bridge and the tip so they meet in a balanced S curve, then closes the incision and places a splint to hold the bridge in place. The length of surgery varies with how much work is involved.