What is Pollybeak Deformity?

Also known as supratip fullness, or colloquially as parrot beak nose or beak nose, a Pollybeak Deformity is an abnormality of the nose contour which can arise following Rhinoplasty surgery.  

Pollybeak Deformity is characterised by a prominent dorsal hump (a raised area over the bridge of the nose) and a lowered and hooked nasal tip, similar to the shape of a parrot’s beak. It is important to understand that Pollybeak Deformity is a relatively uncommon complication following Rhinoplasty, and your surgeon will discuss your personal risk of it occurring during your consultation.

Although a parrot beak nose after Rhinoplasty is uncommon for the majority of patients, many patients are still concerned about it, and our surgeons are regularly asked about it. If it does occur, it can impact confidence, commonly a concern that patients want to address with Rhinoplasty anyway. This may take away from the results of the Rhinoplasty surgery a patient has chosen to undergo, impacting their confidence further. 
 

What Causes Pollybeak Deformity?

Pollybeak Deformity causes arise from Rhinoplasty surgery. Although this may be due to the Rhinoplasty being unsatisfactorily performed, these issues may also occur due to factors out of the surgeon’s control.

There are two types of Pollybeak Deformity, which are linked to different causes: 

Soft Tissue Pollybeak Deformity

A Soft Tissue Pollybeak Deformity occurs when too much cartilage is removed from the internal nasal structures. Excess scar tissue may then fill the resulting spaces, leading to a full appearance on the bridge and tip of the nose. This may impact the contour of the nose, giving a larger and less smooth line to the nose.

Cartilaginous Pollybeak Deformity

In comparison, Cartilaginous Pollybeak Deformity occurs when not enough cartilage is removed from the nose, usually when a bump on the nasal bridge is reduced, but only the bony portion of the nose is reduced. Although the initial swelling may give the nose a straight appearance, as this reduces, the cartilage above the nasal tip can remain prominent, giving the appearance of a Roman nose. 

Bearing in mind that one of the principal outcomes patients wish to achieve following a Rhinoplasty is a smooth and even nose contour, having a more crooked appearance to the nose is not desirable. The development of a Pollybeak Deformity is usually frustrating and disappointing.  

How to Tell the Difference Between Pollybeak Deformity or Swelling

Supratip swelling after a Rhinoplasty is common and depending on the nature of the procedure and various personal healing and recovery factors, can last up to twelve months following your surgery. For some patients, this can feel concerning, and it is important to attend your follow-up appointments with your surgeon and nurses to monitor the progress of your healing.

In the early stages of recovery, it may be challenging to tell supratip swelling and a Pollybeak Deformity apart. The main difference is that swelling will resolve in time whereas a Pollybeak Deformity will remain once the results of your Rhinoplasty have revealed themselves. It is important to be patient throughout the recovery process and to follow your surgeon’s aftercare advice to ensure you achieve your desired results.

If you are still concerned about the contour of your nose six to twelve months after your procedure, it is essential to speak to your surgeon to allow them to assess the results and advise on the best solution for you. 

How to Fix Pollybeak Deformity

Effectively addressing a Pollybeak Deformity may be a long process as your surgeon may wish to explore different solutions and will want to ensure you have an effective and permanent solution. 

Speak to Your Initial Surgeon

Although developing a Pollybeak after Rhinoplasty surgery is disheartening, speaking to the surgeon who performed your procedure is essential. Initially, it can feel as though it is their fault and that the concern has arisen because of inexperience on their part, however, they need to be aware of your concerns and have the opportunity to address the issues. Understanding the difference between a high-quality surgeon and a less experienced surgeon is important at this stage:

A high-quality surgeon will:

• Take your concerns seriously and ensure you feel listened to
• Ask to speak to you so they can discuss your concerns. If this initial discussion is over the phone, or a video call, they may ask to see you in person, so they can assess your nose in person
• Explain why the complication has occurred, offer you a range of Pollybeak Deformity correction options and give you time to consider your options
• Remain in contact with you to allow you to ask questions and support you through the complication
• In some cases, they may ask a colleague for advice and a second opinion. This does not indicate a lack of experience or dismissing your concerns, but that they wish to give you the best range of support available

Signs of a surgeon with less experience include:

• Dismissing your concerns and not giving you the time to discuss your worries
• Not thoroughly assessing the results of your surgery or being reluctant to accept it has arisen from their work
• Placing blame on your recovery and aftercare
• Giving you limited treatment options and rushing you to make a decision
• Not providing support while you navigate your concerns and complications
• Telling you to go and speak with another surgeon without their support

Cadogan Clinic has brought together the best Rhinoplasty and ENT surgeons in the UK. They are focused on providing the best quality patient care and surgical outcomes possible. Additionally, they are supported by our experienced clinic staff and CQC Outstanding-rated leadership team. 

Non-Surgical Pollybeak Deformity Treatments

Depending on the type of Pollybeak Deformity you have, your surgeon may suggest different treatment options to correct the contour of your nose. It is likely that they will initially suggest a non-surgical treatment option for Pollybeak Deformity correction as this will be less invasive. 

Steroid Injections

For patients with Soft Tissue Pollybeak Deformity, steroid injections can be performed to break down the excess scar tissue within the nose. Corticosteroids break the bonds between the collagen fibres within the scarring, reducing the scar tissue and making the nose contour smoother and less rounded. This can be highly effective for many patients and means that further surgery isn’t required. Multiple sessions of injections may be needed over a few weeks or months, and consistency of treatment is important to ensure the best results. 

Dermal Fillers

For some patients, small amounts of Dermal Filler being injected into the nose can improve the contour of the nose, giving a smooth and even line. However, Dermal Filler is not a permanent solution and will require regular maintenance appointments every 6-12 months. As most patients who opt for Rhinoplasty are looking for a permanent solution to their concerns, Dermal Filler may not be a long-term solution, but may offer a short-term option while other options are considered. 

Surgical Pollybeak Deformity Treatments

In cases where non-surgical treatments for Pollybeak after Rhinoplasty haven’t been successful, or where non-surgical options cannot address the underlying cause, surgery may be required. 

Revision Rhinoplasty

As Pollybeak Deformity arises as a complication after Rhinoplasty surgery, the most effective surgical solution is a Revision or Secondary Rhinoplasty. Revision Rhinoplasty can be performed by the same surgeon who carried out your initial procedure, or a different surgeon. It is important to speak to your initial surgeon to allow them to assess your concerns and offer solutions.  

There are several reasons patients choose to see a different surgeon for a Revision Rhinoplasty:

• They have been referred to a different surgeon by their initial surgeon
• It has been a number of years since their first procedure and their initial surgeon is no longer operating
• They aren’t satisfied with the service provided by their first surgeon, despite speaking to them about their concerns

Revision Rhinoplasty involves reopening the nose and addressing the cause of the Pollybeak Deformity. For a Soft Tissue Pollybeak Deformity, this may involve removing the excess scar tissue and placing grafts to prevent the spaces from being filled again with further scarring.

For a Cartilaginous Pollybeak Deformity, the surgeon will remove the cartilage that should have been reduced during the initial procedure and may also use grafts to support the nose effectively.

Finding the right treatment option for Pollybeak Deformity is crucial to ensuring an effective long-term treatment that achieves your desired outcomes and addresses the concerns you had before your first Rhinoplasty and the beak nose. 

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