Bulbous Nose Rhinoplasty: Customized Design is Key!

Hello.

This is VIBE Plastic Surgery.

Among all plastic surgery procedures, the nose is an area with high demand regardless of age or gender.

However, rhinoplasty can be highly difficult to perform as a revision surgery and may cause discomfort or side effects. Therefore, in the case of a bulbous nose, it is crucial to achieve proper improvement during the initial surgery.

Let’s take a closer look at what defines a bulbous nose and the various surgical methods used for bulbous nose rhinoplasty.

Types of Bulbous Noses

Cases where the nose looks spread out because it is low

The tip of the nose should extend sufficiently, but if it collapses without support, it spreads sideways. This makes the nose look wide and gives it a bulbous appearance.

Cases with thick skin and soft tissue

This is often referred to as a ‘strawberry nose.’ If you look closely at a strawberry, the pores are wide and seeds appear embedded. If the nose gives a similar impression, it can be considered a bulbous nose.

Cases where the cartilage itself is large and spread out

Visually, the nose lacks definition and appears spread out to the left and right, creating a bulbous look.

Cases where the alae (nostrils) are wide on both sides

Because the nose looks low and wide, it can strongly project a bulbous impression.

Bulbous nose rhinoplasty varies depending on the shape of the nose.

For cases where the nose looks spread out because it is low, raising the bridge and the tip to visually pull the features together can lead to high satisfaction and significant improvement.

In cases where the skin and soft tissue are thick, there are limits to correction. Removing too much skin just because it is thick can actually lead to a poor aesthetic result. It is better for the final outcome not to over-remove tissue.

Cases where the cartilage itself is large and spread out often yield high satisfaction and good results. This is because simply gathering the cartilage and removing the wide portions can make the nose look sharp and defined. Among bulbous nose surgeries, this type is relatively easy to improve with high satisfaction.

For those who still feel their nose looks spread out even after bulbous nose rhinoplasty, we recommend a procedure called ‘Alar Reduction.’

Rather than choosing alar reduction as the first option, it is better to view it as a conservative procedure for the remaining width after the nose tip has been sufficiently raised.

One side effect of bulbous nose rhinoplasty is the nose becoming even larger after surgery. The skin and the soft tissue beneath it are rich in blood vessels and prone to bleeding. If one tries to make that area thin by removing tissue excessively, new scar tissue (fibrosis) will fill the space. This also leads to significant minor bleeding. If the surgery ends without sufficient hemostasis, the blood in that area can harden, resulting in a nose that is harder and larger than before.

Therefore, since it is important to find a solution that fits the cause, bulbous nose rhinoplasty must be planned and performed as a customized surgery for each individual.

In cases of low height, simply increasing the height and gathering the tissue in the process often results in a visual change and high satisfaction. However, if the bulbous nose is already high and the nose is too large to be raised further, the surgery can be challenging.

As such, there are various types of bulbous noses, and the results inevitably vary depending on the surgical approach and technique used.

To ensure satisfaction in bulbous nose rhinoplasty, Dr. Yu Young-moon, a board-certified plastic surgeon at VIBE Plastic Surgery, approaches the procedure from various angles—including the bridge, nostrils, and columella—to establish and execute a harmonious design plan.