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bulbous tip

Management of bulbous tip starts from analyzing what is contributing to the bulbous look of the nose. Contributing factors include large cartilage, thick fat tissue, thick dermis, and relativley flat nasal dorsum. Surgery of the bulbous tip includes reducing the large tip cartilage, removal of abundant subcutaneous fat, and reinforcing the tip with cartilage grafts. Simultaneous dorsal augmentation and tip elevation also help to relieve the bulbous look. Limitation in improving the bulbous tip comes from the thick dermis. Dermis is an essential component of the skin, so it must be preserved. In this case, retinoic acid such as Accutane or Roaccutane can be used cautiously to thin out the dermis. This should be used preoperatively to thin the thick dermis.



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