I frequently see patients who are interested in rhinoplasty but have preconceived notions of what they want. Often it is the case that they express and interest in a “small” procedure or a “tip” rhinoplasty.
There are certainly examples of patients who benefit from surgery only one sub-feature of the nose, the tip, lets say. But it has been my experience that the overwhelming majority of patients who come to see me for surgery of the nose will benefit from a full rhinoplasty. It is rare that only one sub-feature of the nose is out of aesthetic kilter. Usually the entire nose has characteristics that benefit from subtle modification. Thus, it is my opinion that in these patients if a “tip” rhinoplasty only is performed, while the tip may be improved, the remainder of the nose has characteristics that are aesthetically distracting and the nose lacks balance.
I will performed “tip” rhinoplasties when they are indicated or if a patient desires that and nothing more, but I try to educated patients about the goals of improving upon the nose in its entirety so that at the end of the procedure all of the modified sub-features have synergistic affect on a balanced final appearance. I think it is this final balance that creates a natural look at the end of a rhinoplasty. The balance is also what makes the “new” nose work in the harmony with the rest of the face to improve overall appearance. While on the other hand, a new tip on an unaltered nose often can be picked out as a “nose job,” at least by me it can. (again this is my opinion and other good surgeons have their own perspective on this matter).