How it works
Everything begins with a consultation. Your surgeon looks at the tip of your nose from several angles, feels the firmness of the cartilage and the thickness of your skin, and then listens as you describe what you want to change. Thicker skin hides the lines of the cartilage, so the result tends to be more subtle in people with thick skin than in those with thin skin. This is the time to ask every question you have and to be clear about what you hope for.
Tip refinement is usually carried out under local anaesthetic with sedation, or under general anaesthetic, depending on how much work is needed and the habits of the clinic. Your surgeon will talk through the right choice with you before the day of surgery. The incisions are usually placed inside the nostrils, sometimes along with a small cut across the narrow strip of skin between the two nostrils (called the columella), depending on the technique chosen.
Through these incisions, your surgeon reshapes the lower lateral cartilage so the tip becomes neater and more balanced. Depending on your structure, your surgeon may remove a small amount of excess cartilage, place stitches to draw the two pieces of cartilage closer together, or set a small piece of cartilage, taken from your own septum, in place to add support. The aim is a tip that is stable and natural, not one made so thin that it becomes weak or uneven.
When the work is finished, your surgeon closes the incisions with fine stitches. You may be given a splint or an outer dressing to hold the shape and ease swelling in the first few days. Most people go home the same day, after resting and being watched until they are stable.