What are the causes of a pollybeak deformity?
A pollybeak deformity, also known as supra-tip fullness, is an undesirable side effect of a less-than-successful rhinoplasty procedure. It manifests as an unusual fullness above the nasal tip, affecting the desired nasal contour. The area above the tip of the nose on the bridge is the highest part of the nose when seen in profile. The rather unflattering term ‘pollybeak’ comes from how the nose resembles a parrot’s beak.
“Rhinoplasty is a complex procedure, and there’s a fine balance between lowering the bridge too much and giving the appearance of a saddle deformity and not lowering the bridge enough and causing a pollybeak deformity,” explains rhinoplasty expert Mr Annakan Navaratnam.
“There are multiple factors involved, which include the thickness of the patient’s skin, the cartilage position and the potential functional compromise that can occur.
“To avoid a pollybeak deformity, I always make careful assessments of the thickness of the skin and nasal anatomy. I also typically use a technique called a septal extension graft, and there is evidence that it maintains the tip position much better in the long term.”
Pollybeak deformity causes
This rhinoplasty complication can occur due to two main reasons:
Soft tissue pollybeak
One type of pollybeak deformity is the soft tissue variant. This usually occurs when too much of the underlying cartilage structure is removed during the initial rhinoplasty procedure. Skin thickness is also a factor. If the skin is relatively thick, the resulting space can fill with scar tissue, leading to a noticeable fullness.
Cartilaginous pollybeak
The other type is the cartilaginous pollybeak deformity. This happens when the rhinoplasty surgeon reduces a bump on the nasal bridge but focuses only on the bony portion without sufficiently reducing the cartilaginous part. Post-surgical swelling may initially mask this issue. However, the unaddressed cartilage above the nasal tip can remain prominent as the swelling diminishes.
Pollybeak deformities are relatively uncommon and typically result from technical errors during the initial rhinoplasty. This underscores the importance of selecting a skilled, experienced surgeon for rhinoplasty procedures.
The appearance of a pollybeak deformity usually becomes noticeable about three to four months after surgery, as post-surgical swelling subsides. However, the exact timing can vary based on individual healing rates and the nature of the deformity.
What are the solutions to a pollybeak deformity?
Hyaluronic acid dermal fillers – also referred to as a liquid nose job – can help augment the nasal profile and lessen the look of a soft tissue pollybeak deformity. Patients looking for a non-surgical solution may find this appealing, but the results are temporary, and the procedure may need to be repeated every six to twelve months.
In cases where a cartilaginous pollybeak deformity is present, revision rhinoplasty surgery is usually required. This involves a secondary rhinoplasty to further reduce the excess cartilage that was not adequately addressed in the initial surgery and reinforce the nasal tip for a more balanced and aesthetically pleasing outcome.
The importance of choosing an experienced surgeon
Choosing an experienced surgeon is critical when considering any rhinoplasty. The surgeon’s expertise in rhinoplasty procedures, understanding of nasal anatomy, and ability to manage potential complications are all factors in achieving a successful outcome.
“Once surgery is undertaken, there’s not too much you can do to avoid it thereafter. Careful planning of the initial surgery is key,” concludes Annakan.
For more advice on possible rhinoplasty complications and how they will be managed, call +44 (0)203 627 2918 or email secretary@annakan.co.uk to arrange a consultation with rhinoplasty surgeon Mr Annakan Navaratnam.
