#NoseByNayak

What makes a nose truly beautiful? Removing the bump on the bridge and the ball at the end isn’t enough!
The answer lies in creating a truly elegant nasal tip. Mastering the dynamics of nasal tip control is widely considered one of the greatest challenges in plastic surgery. It humbles me, still, every day.
In this video, I give you a tiny bit of insight into some of the challenges I face when reimaging the nasal tip and demonstrate a couple of the million and one techniques I employ to create the shapes I’m after.
**Please note - there are 3 surgical photos shown between 8:15 and 10:23. They are not too bloody or gross, and most people would be fine with them. I decided to include them because they are truly educational in illustrating what the inside of a “pretty” vs “not-so-pretty” nasal tip looks like.
Surgeons, you can watch this entire surgical case, and 7 more, in my new Mastering Rhinoplasty video series available to stream at qmp.com!
Please let me know if you like this content, what questions you have, and what else you’d like to learn about rhinoplasty!

[@rochelleakos]

this is hands down the best and most informative tip pasty video I've seen over YEARS of research. Thank you so much, Dr. Nayak. if anyone has tip pasty doc recommendations in NYC, lmk lol

[@CarriedAwayChannel]

Amazing! She looks so beautiful! Great job! Loved the tutorial and definitely wasn’t too graphic at all. I love it.

[@natalienetanya7401]

Thank you for the education. I wish more doctors would be willing to educate us.

[@sonyaphillips4027]

Loved it, very informative and important, love your graphics as well, all of it was educational👏👏👍😇🥰😀

[@julesjules1565]

Beautiful work. How I wish I can travel to see you now!💗

[@jeaninemartin]

Great teacher!!! Very knowledgeable!! No those pictures were not too graphic at all in answer to your question. Very pleasant speaking voice. Emily’s nose looks beautiful, I’m sure it has changed her life. Enjoyed your tutorial. There are a lot of bad nose jobs out there…I hope you teach.

[@kellilangvo]

That’s an amazing outcome! Do you suggest refining just the nasal tip for patients with thicker skin? Can you address why as we age our noses seem to get bigger? 😐I know mine has widened and drooped now that I’m in my 50’s. Are outcomes more consistent with addressing just the nasal tip than a full rhinoplasty?…..I know this video is geared toward practitioners but I find it fascinating how you break down the nuances of the surgery….and makes me wonder if most surgeons have the knowledge and skill to break down the process with such precision…..

[@gentlebeestar3140]

Thanks for sharing.Educational and even understood by a lay person.

[@mypletunia3281]

Beautiful job!

[@MayaRaimondo]

LOVE IT!!!!! Finally addressing the supratip.

[@user-xb5zu6zu7j]

Amazing result

[@Shells84]

She looks amazing. learned this the hard way.

[@JSD999]

at time 7:06 he mention common suture doom to failure best video i seen in 1000 watched

[@entdrferozkhan]

Excellent demonstration and simple explanation without using heavy aesthetic word jargon ❤❤❤ Want to learn more techniques from you doc . Where should I log in to know more

[@kdlf333]

Can’t wait for you to do mine 🤪

[@cheryldavis8776]

Is this procedure considered an open or closed rhinoplasty? Emily's outcome ia spectacular! What a lovely nose you crafted for her.

[@Lppt87]

That’s a very good surgery. Good hands.

[@danielamadero3227]

Dos you needed to break the bone or just worked on the tip? Beautiful job 🤩

[@xenotbbbeats7209]

I wish I had run into you years ago. Back when I had the money, I had a 2nd adult correction to my nasal tip. I was born with cleft lip only, but it created a nose that was too flat at the tip. At 19, I had the first rhinoplasty, which was dibble-tip. My nose was still upturned as it was prior, and matched my whole family's. A few years later, noting an abrupt recess at the top of my filtrum, I had a prosthesis implant inserted where bone was missing due to my deformity. It gave me some base, but no projection. In my early 40s, I had a 2nd radical open deviated septum surgery because my breathing was substantially blocked, and cartilage from behind my ears was harvested to add more projection. The surgeon initially overshot by adding both more upper bridge (which I did not need at all) and nasal tip and I looked like Cher (someone even told me that), which to me, was horrifying (I liked "Suzanne Plachette" better which is what I heard before), so he removed that very soon after and used cartilage at the tip. Again, the projection is just not there, but more devestating, my nose now points down slightly. I lost the cute upturned nose. I keep hearing that you should not get a 3rd surgery, but I feel like an imposter when I see my profile. It is weak, unattractive, ages me, and makes me look sad or angry. I'm an extrovert, so it doesn’t match my personality or my entire family's trait of an upturned nose. I can't afford to get constant injections and don't like the idea of a foreign injectible that could migrate. I keep hearing about silicone nasal implants, but NOBODY in the U.S., at least not out where I am, seems to do that. I only need a radical strengthening of the medial crus to create more projection, and lift, with a noticeable supratip break to bring back my upturned "happy" nose. This is so frustrating. I'm now approaching 60 and people likely wonder why I care. I suppose you have to have been born with cleft lip to understand. The surgeons were very skilled at making the scar nearly undetectable. But none have figured out how to give someone MORE nose.

[@RP-lg3wt]

@NayakPlasticSurgery is there a way you couldve used to keep the tip from plunging on smiling but not raise it as much?

[@lm7338]

Contrarian here, I think her before tip is the "elegant" and "truly beautiful" one. Lookin like a roman or greek statue is pretty cool. Because fewer people seem to agree with that, there are few to opt to lower their tip (something Id like to do) Therefore it feels risky to consult about, how realistic is it to lower a tip by around 1 cm?

[@Moniq29uk]

I have 1 Year and 8 monts since my primara septorhinoplasty and the tip of my nose is still too high, too upturned, and the bridge looks scooped just over the tip. Is it possible to have a small revision just to lower the tip of the nose or it will drop by itself overtime

[@zeeazi544]

I always wonder what happens to the extra skin from the droopy nose ? Excision?

[@GaneshadevaRas]

I am from India I love your work how much does it cost for tip correction

[@omarbr90]

Hi Dr. Nayak, when I smile and talk, my upper lip doesn't move up enough to show upper teeth, which makes me look weird and I think it's because of the drooping nose tip. My question is, if I do a nose tip lift surgery, will it also lift/reposition my upper lip in order to fix the problem?

[@robbieoneill4364]

Where are you located? I would like to schedule a consultation

[@directajith]

Did you take the top bone in this case? ( It appears different)

[@DK-ox7ze]

I had revision rhinoplasty 3 weeks back to bring down the tip as my previous surgeon over rotated it which gave piggy appearance. But I am not quite happy with the results as the tip hasn't come down to my desired level. How likely is the tip to drop in coming months? My surgeon inserted ear grafts in the bottom center to bring down the tip.

[@kandipennington9233]

What’s the down time??

[@smitha5022]

We could play a game called just the tip. Just for a second just to see what it feels like. Or ouch, ouch, you're on my hair...🤣🤣🤣🤣🤣🤣🤣

[@bernadettebohan5822]

wow

[@LexaTerrestrialx]

should have gone to you for my nose 😂 truly

[@sj1684]

The best! But I liked her nose before, it had a unique shape!

[@altonethtorres6690]

Your the doctor that I was looking for...sad to say I'm far 😢

[@Hi-ts1ur]

My nose is exactly like hers. It is so painful to see how I can become beautiful and get rid of bullying, Unfortunately i cannot do this surgery 😢 I do not have the money.

[@GYPSYGARGOYLE]

Hey first I want to say I'm so sorry you're bullied. I want to say two things. When ever I was feeling insecure about my nose I would look at ryan Ashley, she is so gorgeous despite not having the perfect nose (this gave me confidence despite my insecurity) second: you can do something about it, if you really want to! I went the insurance route for my surgery(different surgeon) but as I look back I should have gone the care credit route and paid out of pocket. My initial surgery was around 14 grand after paying for insurance for 5 years until I can figure out who I could go to. 4 grand out of pocket. However they unfortunately used me as a guinea pig for students.... and then they realized my nose was alot worse then the thought once they opened me up😮‍💨 which I told them I was punched in the face by my ex step dad. 😅 they never took x-rays which would have helped i.m.o. but oh well. I honestly was not a good candidate for students... due to the emotional trauma behind my nose. but moving forward I cut off my health insurance and got care credit. You need a score of 680 they fund you more if you have a higher score, mine was around750 when i applied. If you have any questions about credit or need advice. I got you. I plan to get a revision on my left nostril... because I think they just forgot to suture me. So there's some sagging on that side now, which the skin hang impacts my air flow. But when I push up my tip I breath so great. My nasal tip was more up before my surgery for whatever reason he decided to change it which I remember telling him explicitly. I like my nose I just want septum and hump fixed. But my tip is weak now. So I think he failed to but me back to my original look. 😮‍💨 I look different from the front now and I absolutely hate it. My insecurity was only side view initially(b4 sugery) now I feel like Mr potato head. And then triggered constantly remembering all the abuse I endured from my ex step dad. OK sorry tmi. I should of gone the out of pocket route because maybe they would have been less inclined to f*** around and done a better job 😅 😔 OK sorry tmi. I hope you get the nose of your dreams and tell those bullies to f*** off because you don't deserve that negativity in your life,

[@nourahali86]

Can this be done under local anesthesia?

[@streamepiphany9932]

I wonder the same thing

[@lifewiththekids]

OMgeez! That sounds like a truly horrible experience! I’m claustrophobic and would probably run away as soon as I saw a bunch of hands working that close to my face. 😰🙈 🏃🏻‍♀️💨 😂😂

[@hanan1734]

From the front look so different and not pretty

[@III-mu4yn]

Copy paste the same noses on everybody's face. It looks like an obvious nose job as usual.

[@alexlopez-sh3si]

how to contact you