A pollybeak deformity is a specific contour irregularity of the nose, characterized by fullness just above the nasal tip. This condition can significantly alter the nasal profile, creating an appearance resembling a parrot’s beak. It impacts the nose’s overall shape and aesthetic balance. This article explores its characteristics, common causes, identification, and correction methods.
What Exactly is a Pollybeak Deformity?
A pollybeak deformity is a rounded prominence in the supratip area, the region of the nasal bridge immediately above the nasal tip. This fullness makes the nose appear to droop downwards, disrupting the desired straight or gently curved profile. When viewed from the side, the highest point of the nose becomes this area above the tip, rather than the tip itself. The term “pollybeak” stems from its visual similarity to a bird’s beak.
This contour abnormality can range in severity, influencing the overall balance and harmony of facial features. The presence of this convexity can make the nasal tip appear less defined or even pushed downwards.
Why Does Pollybeak Deformity Occur?
Pollybeak deformity can arise from natural causes or develop after nasal surgery. While less common, some individuals may have a pollybeak as a natural nasal feature due to overgrowth of septal cartilage or nasal tip cartilages. However, the condition is most frequently associated with complications following rhinoplasty.
A common cause after rhinoplasty is insufficient removal of cartilage or tissue from the supratip area during the initial procedure. If a dorsal hump is reduced but the cartilaginous portion above the tip is not adequately addressed, excess tissue remains. Another factor is the formation of excessive scar tissue in the supratip region. This often occurs in patients with thicker skin or if too much cartilage was removed, creating a space that then fills with fibrous tissue. Insufficient support for the nasal tip can also cause it to drop, making the supratip area appear more prominent.
Recognizing and Diagnosing Pollybeak Deformity
Identifying a pollybeak deformity begins with visual observation of the nasal profile. Individuals may notice a rounded, prominent area on the bridge of the nose just above the tip, which appears to overshadow or push down the tip. This noticeable convexity, rather than a smooth transition from the bridge to the tip, is a primary visual cue.
Diagnosis involves a physical examination by a medical specialist, such as a plastic surgeon. The specialist assesses the nasal structure and profile through visual inspection and palpation. Palpation helps differentiate between a firm fullness (excess cartilage) and a softer, more compressible fullness (soft tissue or scar tissue). While initial swelling after rhinoplasty can mimic a pollybeak, a definitive diagnosis is generally made several months after surgery, typically three to six months, once most of the initial swelling has subsided. Many surgeons recommend waiting up to a full year for complete healing before making a final assessment.
Approaches to Correcting Pollybeak Deformity
Correcting a pollybeak deformity involves revision rhinoplasty, a surgical procedure addressing issues from previous nose surgeries. Surgical goals include reducing supratip prominence, refining the nasal tip, and creating a smoother, balanced nasal profile. This may involve removing excess cartilage or scar tissue, or using cartilage grafts for tip support or reshaping.
For cases with excessive scar tissue or prolonged swelling, non-surgical options may be considered as an initial or adjunctive measure. Steroid injections, such as Triamcinolone acetonide, can be administered into the supratip area to break down scar tissue and reduce inflammation. These injections are more effective in the early stages, within the first year after initial surgery. Multiple sessions may be necessary, and careful administration is important to avoid potential side effects. Dermal fillers offer a temporary non-surgical approach for mild to moderate deformities, camouflaging the bulge by smoothing the nasal contour, though they do not resolve the underlying structural issue.