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pollybeak deformity

Pollybeak Deformity: Why It Develops & How To Treat It

After rhinoplasty surgery, it’s possible for patients to experience complications. Some of them are only temporary, but others may need surgical intervention. Pollybeak deformity is one such complication. 

Some cases can be predicted or even prevented, but that’s not always possible. It’s important that you have an understanding of this problem, so you can clearly communicate your concerns to your surgeon before or after the rhinoplasty. 

What Is Pollybeak Deformity?

“Polly” typically refers to a parrot, so pollybeak means the beak of a parrot. It is also known as supratip deformity. According to a study published in the Plastic and Reconstructive Surgery, its incidence rate was 9% in patients who had their first rhinoplasty. So, it’s not that common. 

In the pollybeak deformity, there’s an over projection of the supratip of the nose in relation to the tip, which lies right underneath it. There are two different types of pollybeak deformities: 

  • Cartilaginous pollybeak: As the name indicates, this deformity results from the insufficient removal of cartilage along the bridge of the nose. 
  • Soft-tissue pollybeak: This develops due to thick skin and formation of scar tissue in the supratip of the nose. 

It should be noted that some patients get confused between the swelling after the surgery and pollybeak deformity. It is possible for the swelling to hide this complication. You can have swelling for as long as a year after rhinoplasty. Therefore, you can’t know for sure if you have this problem until then. 

For this reason, your doctor may recommend delaying the revision surgery for pollybeak deformity for at least a year. Meanwhile, it is also important for your nose to recover and heal from the previous surgery. After the year has passed and you still have the characteristic “parrot beak” nose, then you can consider getting this revision surgery. 

What Causes Pollybeak Deformity?

Although many people develop this after getting a nose job, there are certain risk factors to look out for: 

Surgical Errors

Most often, this problem is caused by inexperienced surgeons. That’s because it’s important for the surgeon to have an understanding of the anatomy of the nose. 

In addition, they need to have knowledge of the possible consequences of making changes to it. Sometimes this problem results because the surgeon is unable to predict how the nose of a particular patient will recover after the surgery. 

Many things can go wrong and cause pollybeak deformity. When a specific part of the nose is removed too much or too little, this can occur. It could be due to one or more of the following: 

  • Aggressive or insufficient removal of the bridge of the nose
  • Aggressive removal of the nasal bone
  • Improper skin redraping over the nose 
  • Aggressive removal of cartilage in the lower half of the nose

There are some things that the surgeon needs to take into consideration. For instance, if a large part of the nasal bridge was shaved down, the skin over the nose will have to be adjusted accordingly. If too much of it is left, it will bunch up over it and develop into scar tissue, resulting in a bulbous supratip. 

It’s also possible that the reduction in the bridge of the nose results in a lack of support for the tip, which can also result in pollybeak deformity. An inexperienced surgeon can damage to the underlying structures of the nose during the surgery, which can result in its collapse. 

Thicker Skin 

A reason behind the formation of soft tissue pollybeak is thick skin. Those who have thicker skin are already at a risk of developing this deformity. 

Thick skin bunches up over the supratip of the nose. After the removal of the cartilage from the nose, it is unable to contract properly over it, resulting in this problem. Another reason behind this complication may be, again, the inexperience of the surgeon. 

It’s possible that they end up removing too much of the cartilage for a more dramatic change. Not only will skin be unable to contract properly, but also, there won’t be enough supportive structure for the supratip/tip. This can result in its collapse, resulting in a pollybeak. 

Since people with thicker skin experience more swelling and scarring, it won’t be possible to tell apart the different post-op complications for a little longer than usual. It is possible that you may have to wait longer than a year to get your revision surgery. It is the responsibility of the surgeon to inform the patient of the likelihood of this complication before the surgery takes place. 

Negligence In Aftercare 

Since one type of pollybeak deformity is a result of excessive scarring, it is important that you follow the aftercare instructions. Your doctor will recommend avoiding strenuous physical activities and contact sports for a few months. 

That’s because they carry the risk of injury. If you don’t follow them and experience a traumatic event that injures the nose, it is possible that you end up developing a pollybeak deformity. 

How To Know If You Have Pollybeak Deformity?

After the swelling has subsided, your nose will have a convex profile like that of a parrot. In some cases, it is quite subtle, but it’s visible enough to the patient. A before/after photo comparison can further highlight the change. However, you should consult your doctor about this. It is also possible to have breathing problems if your nasal structure is damaged. 

How to Treat Pollybeak Deformity?

To treat pollybeak deformity, you can undergo revision surgery. Depending on the kind of pollybeak you have, you may need to get the cartilage reshaped. It’s also possible that the position and size of the nasal bridge are readjusted. Grafting may also be needed. 

It is also possible that you may experience complications from this second rhinoplasty. That is why it’s important that you discuss these in advance with your doctor. You should also discuss any other treatment options for pollybeak deformity. Make sure to find a surgeon you can trust. 

Poor surgical technique can result in permanent damage to the underlying tissue, other than deforming the shape of your nose. Your surgeon needs to understand the possible reasons for your supratip deformity, as well as have the technical skills to address it appropriately. 

What Should You Do If You Have Pollybeak Deformity?

If you have pollybeak deformity, there is no need for alarm. Make sure to get in touch with your surgeon and discuss the potential treatment options with them. Successful recovery from this is possible. 

Just keep in mind that you will have swelling after rhinoplasty, so you can see the final results at least for year. Before that, your surgeon will also follow your recovery through the images that you share with them. So, you’d know if there’s a problem. 

Some patients find that their nose looks fine in the beginning but deforms after some time has passed. This is also possible. And if at any time during the recovery, you notice anything like this happening, you should get in touch with your doctor as soon as possible. 

Concluding Remarks 

Pollybeak deformity is an uncommon complication of rhinoplasty. In this, the patient ends up with convexity to their nose that resembles the beak of a nose, hence the name. Depending on the problematic areas, there are two types of pollybeak deformities. And there are different reasons why you may end up developing them. 

Mainly, inexperienced surgeons can cause this issue because they lack an understanding of the structure of the nose and how it will heal after the nose job. There are people who end up with pollypeak deformity even after their second revision surgery. However, there are other risk factors that are out of the hands of the surgeon. 

Thick skin, for instance, which has been reported in Asians and Africans, puts them at a greater risk of developing pollybeak deformity. If this is the case, your surgeon should inform you about this before the surgery. Any injury during the aftercare may become another potential cause of this problem. Here, you should also keep in mind that every patient heals in their own way, and it isn’t something that the surgeon can control. 

It can be hard to tell if you have pollybeak deformity soon after you’ve had your first rhinoplasty. That’s because the swelling may make it seem so. You’d have to wait for at least a year to know for sure. Meanwhile, keep in touch with your doctor to make sure that you’re recovering properly. 

If you do have a pollybeak deformity, you may need revision surgery for it. It cannot resolve on its own. Ideally, you should consult with your doctor about the treatment options that are most appropriate for you.

Reviewed and approved by Prof. Dr Fuat Yuksel.

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