Understanding Polly Beak Deformity and its Relationship with Rhinoplasty
For many people who opt for rhinoplasty, the primary goal is to achieve a more aesthetically pleasing nose shape and improved breathing. However, this procedure has its complications, with Polly Beak Deformity being one of the most common.
We will cover frequently asked questions about this complication, along with the causes, prevention, and treatment of polly beak deformity. If you are a rhinoplasty patient considering or undergoing nose surgery, or if you are concerned about polly beak deformity, this blog post is for you.
What is Polly Beak Deformity?
Polly Beak Deformity, also called supratip fullness, is a condition that occurs when there is an overgrowth of the scar, fat, or cartilage in the supratip area of the nasal bridge, causing a visible bump or fullness in that area.(1) This deformity exposes cartilage, which appears like a parrot's beak, and pushes the nasal tip downwards, leading to underrotation.
What Causes Polly Beak Deformity?
Polly Beak Deformity, also called supratip fullness, is a condition that occurs when there is an overgrowth of the scar, fat, or cartilage in the supratip area of the nasal bridge, causing a visible bump or fullness in that area.(1) This deformity exposes cartilage, which appears like a parrot’s beak—sometimes referred to as a 'beak nose' due to its distinctive shape—and pushes the nasal tip downwards, leading to underrotation. The prominence in the supratip area and changes along the nasal bridge are closely related to the underlying nasal anatomy, which is important for understanding the basis of this deformity.
Types of Polly Beak Deformity
Polly beak deformity can be categorized into two primary types: cartilaginous pollybeak deformity and soft tissue pollybeak deformity. Cartilaginous pollybeak deformity occurs when there is too much cartilage left in the supratip region of the nose, often resulting in a noticeable nasal hump or beak-like appearance. This type of beak deformity is frequently seen after primary rhinoplasty if the surgeon does not remove enough cartilage or if there is poor healing of the nasal tissues. On the other hand, soft tissue pollybeak deformity is caused by an accumulation of excess scar tissue or swelling in the same area, leading to a rounded or full look above the nasal tip. Soft tissue pollybeak deformity can be particularly challenging, as it may require careful removal of excess scar tissue or the use of dermal fillers to restore a natural looking nose profile. Understanding the difference between these types is crucial for both patients and surgeons, as the treatment approach will depend on whether the deformity is due to cartilage, soft tissue, or a combination of both.
What Causes Polly Beak Deformity?
Polly Beak Deformity is caused by several factors like excess scarring in the supratip area, high anterior septal angle, underprojected tip with poor tip support, overresection of the nasal dorsum (also referred to as over resection), short medial crura, thick nasal skin, and overgrowth of the septum or cartilaginous midvault. It can also occur when there is damage to the lower lateral cartilages, tip cartilage, or lower nose during prior rhinoplasties, or the failure to remove excess tissue or excess skin at the tip post-rhinoplasty.
Improper management of the caudal septum and nasal septum can also contribute to polly beak deformity. If the cartilaginous dorsum is not adequately preserved, it may lead to structural issues resulting in the deformity. Accumulation of excess tissue, whether cartilage or soft tissue, in the supratip or lower nose area is a common cause of the characteristic beak-like appearance.
What does Polly Beak Deformity Look Like?
Polly Beak Deformity can take on various appearances, depending on the severity and underlying cause. In general, it appears as a visible bump or fullness in the supratip area of the nasal bridge, creating a parrot's beak-like appearance, also known as a parrot's beak deformity.(1) However, in some cases, it can also lead to underrotation of the tip of the nose or nose tip, resulting in an unbalanced or unnatural-looking nose shape.
Examples of polly beak deformities that required revision rhinoplasty
Can Polly Beak Deformity be Prevented?
Preventing Polly Beak Deformity during primary is key, and proper technique is essential to avoid pollybeak deformity. Providing adequate tip support through overlaying of the lower lateral cartilages and medial crural control sutures can help prevent it. Surgical skill is crucial in preventing this complication, as technical errors can lead to poor outcomes. Choosing an experienced surgeon can significantly reduce the risk of developing polly beak deformity. Patients who develop early signs can try taping or steroid injections to reduce swelling and fullness.(2)
How can Polly Beak Deformity be Treated During Revision Rhinoplasty?
Revision rhinoplasty, a form of corrective surgery and revision surgery often referred to as secondary rhinoplasty, is suitable for treating Polly Beak Deformity. Pollybeak deformity correction may involve a complex rhinoplasty operation to address both functional and aesthetic concerns. The excess scar tissue in the supratip area is removed while tip projection is reduced through cephalic trim, tip suturing techniques, butterfly grafts, and the use of a columellar strut for additional tip support. Dorsal reduction and reconstruction of the midvault can also help to correct a polly beak deformity, involving key anatomical structures such as the alar cartilages, upper lateral cartilage, and upper lateral cartilages, with scar tissue or cartilage grafts for grafting to provide structural support. The nasal bone and nasal bones are also important considerations in surgical planning and execution for optimal outcomes.(3)
Are There Non-Surgical Options for Polly Beak Deformity?
While surgical correction remains the gold standard for addressing most cases of polly beak deformity, there are non-surgical treatment options that may benefit certain patients. Steroid injections can be used to target excess scar tissue in the supratip region, helping to reduce swelling and soften the appearance of the nasal tip. For those with minor irregularities or fullness, dermal fillers can be strategically injected to smooth out the nasal profile and create a more balanced, natural looking nose. However, it’s important to note that these non-surgical options are typically temporary and may require repeated treatments to maintain results. Additionally, non-surgical approaches are generally best suited for soft tissue pollybeak deformity and are less effective for cases caused by excess cartilage or inadequate nasal tip support. Consulting with an experienced plastic surgeon is essential to determine whether non-surgical treatments or surgical correction is the best option for your specific type of beak deformity.
Is the correction of Polly Beak Deformity a Complicated Procedure?
Revision rhinoplasty to correct Polly beak deformity is a challenging procedure that only experienced rhinoplasty surgeons should undertake. This type of correction falls under the broader category of rhinoplasty surgeries, commonly referred to as a "nose job," which includes both primary and revision procedures aimed at altering or restoring the nose’s appearance and function. A competent surgeon can use a range of techniques to give a favorable outcome: one of the most promising strategies is using a cartilage-sparing approach and performing appropriate grafting procedures to provide tip support.
What is Recovery Like After Correction of Polly Beak Deformity?
The recovery process following correction of polly beak deformity will vary depending on the extent of surgery and individual healing factors. Most patients can expect some swelling, bruising, and mild discomfort around the nose and facial area in the days after surgery. These symptoms are typically managed with pain medication and cold compresses. A nasal cast or splint is usually worn for the first week, and most people can return to light daily activities within 1-2 weeks. It’s important to avoid strenuous exercise, heavy lifting, or bending over during the early recovery process to protect the healing nose. Follow-up visits with your surgeon are crucial to monitor progress and remove any sutures. While initial improvements are visible within a few weeks, the final shape of the nose may take several months to a year to fully settle as swelling gradually subsides. Patience and careful adherence to post-operative instructions are key to achieving the best outcome after surgery for polly beak deformity.
How Much Does Correction of Polly Beak Deformity Cost?
The cost of correcting polly beak deformity can vary significantly based on the complexity of the revision rhinoplasty, the surgeon’s experience, and geographic location. On average, revision rhinoplasty procedures to address beak deformity range from $10,000 to $15,000 or more, especially if advanced techniques or cartilage grafts are required. Non-surgical options, such as steroid injections or dermal fillers, are less expensive per session—typically ranging from $500 to $2,000—but may require multiple treatments to maintain results. It’s important to consult with an experienced plastic surgeon to discuss your goals, the most appropriate treatment options, and the associated costs. In some cases, additional procedures may be necessary to address nasal obstruction or other functional concerns, which can also affect the overall price. Investing in a skilled surgeon with expertise in revision rhinoplasty is essential to achieve a safe and satisfying outcome. In cases were the costs are to steep most surgeons offer financing options.
Get Help With Polly Beak Deformity
Polly beak deformity can significantly alter the shape of your nose, and a thorough evaluation of the patient's nose is essential, as there are many different noses that may require individualized treatment. Regardless if it is the result of prior rhinoplasty or due to unique anatomy. If you are looking for help to address the shape of your nasal tip or side profile reach out to Dr. Franck who is an expert in revision rhinoplasty surgery. During your consultation, he will make sure to come up with the right plan for you.
References
1.Rohrich, R.J., Shanmugakrishnan, R.R. and Mohan, R., 2020. Rhinoplasty refinements: addressing the pollybeak deformity. Plastic and Reconstructive Surgery, 145(3), pp.696-699.
2.Hanasono, M.M., Kridel, R.W., Pastorek, N.J., Glasgold, M.J. and Koch, R.J., 2002. Correction of the soft tissue pollybeak using triamcinolone injection. Archives of facial plastic surgery, 4(1), pp.26-30.
3.Hoehne, J., Brandstetter, M., Gubisch, W. and Haack, S., 2019. How to reduce the probability of a pollybeak deformity in primary rhinoplasty: a single-center experience. Plastic and Reconstructive Surgery, 143(6), pp.1620-1624.
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