Bifid tip and bulbous tip rhinoplasty

A bifid nasal tip is the name given to the shape of the nasal tip where a groove is present in the midline. There are a pair of cartilages which form the structure of the nasal tip . If there is a wide space between these cartilages or if these cartilages are very convex in shape a depression may be seen between them. This midline groove then makes the nasal tip appear as two halves which gives rise to the term ‘bifid tip’.

Such an appearance may be completely normal as displayed by the actor Jason Bateman ( photo above ) who is well known for his role in the Netflix series the Ozarks

Surgery to correct a bifid tip appearance

Surgery is possible to obliterate the groove between the pair of cartilages. This usually involves an open rhinoplasty approach where a small incision is made in the skin bridge between the nostrils from below. The skin is elevated in order to gain access to these cartilages.

In mild cases sutures are placed between the two cartilages to bring them together in the midline which obliterates the groove. In some cases the cartilages are convex and produce two  ‘hills’ either side of the groove and reshaping of these cartilages to flatten them is required. Another manoevre in some cases may involve using a small cartilage graft to obliterate the groove.

Of course the exact technique may vary in every individual depending on severity and what else is being performed on the nose. This surgery may be carried out on its own as tip surgery in isolation or more commonly it is performed as part of an overall nasal reshaping.

Typical examples:

This patient of mine below is a typical example where she has a midline groove and in her case this is associated with a bulbous tip at the same time. The bulbous tip is due to the rounded and convex shape of the pair of nasal tip cartilages. In this case the tip cartilages were reshaped to flatten their appearance, the cartilages were stitched together and a small piece of graft used centrally. At the same time this patient has an overall rhinoplasty with a dorsal hump correction



This patient below had a simlar surgery to correct a bifid and bulbous tip. Cartilage reshaping was performed along with a graft in the midline. She also had an overprojected tip which required shortening and deprojection. A dorsal hump correction was performed at the same time. 



This patient below had a mild bifid tip mainly due to thin skin and a separation of the pair of nasal tip cartilages. This was corrected by a suture technique alone to stitch the pair of cartilages together in the midline. a small reshaping to the bridge line was performed at the same time



These techniques are often combined with rhinoplasty in general and you can read more about the specialised and advanced techniques that are employed in my practice on the following pages

rhinoplasty in general

ultrasonic rhinoplasty



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