Do I Perform Cephalic Trim in Rhinoplasty? (Short Answer: Rarely & Barely)

A common question surgeons ask — and patients hear about online and sometimes ask — is whether cephalic trim should be performed to refine the nasal tip.

I use minimal to no cephalic trim in my rhinoplasty cases. In many cases I perform zero.

Why I Avoid Traditional Cephalic Trim

Traditional tip reduction relied heavily on removing cartilage, which often led to:

  • pinched tips

  • weak support

  • collapse

  • alar retraction

  • breathing issues

  • long-term instability

These problems show up frequently in revision surgery.

My Approach: Shape tip cartilage for a beautiful tip rather than remove volume.

Instead of cutting away the tip cartilage, I focus on:

  • Shaping the cartilage to reduce bulbosity as well as to reinforce support at the nostril margin to make a beautiful 3 dimensional nasal tip.

  • cartilage preservation

  • tip repositioning, not reduction

This creates definition without sacrificing long-term strength or resulting in the classic problems associated with cephalic trim..

When I Do Perform Cephalic Trim

In rare cases with very wide, strong lower lateral cartilages, I may remove a tiny amount (1–2 mm) — but only right near the “dome”:

  • support is already excellent

  • the risk of collapse is zero and risk of retraction is zero.

Even then, it’s extremely conservative.

ARI HYMAN