I want a rhinoplasty to get rid of the bump on the bridge of my nose but I don't want to look fake and obvious that I've had nose surgery. How can I get natural-looking results from my rhinoplasty?
How Can I Get Natural-looking Rhinoplasty Results?
Doctor Answers (27)
The key to a natural-looking rhinoplasty result is to focus on your face..not your nose!
I personally believe the single most important factor contributing to a natural appearance following rhinoplasty is maintaining naso-facial harmony. Simply put… at the end of the procedure, does the nose look like it belongs on a particular face? If the answer is yes, then more often than not, the results will be very natural-looking.
Another important point to keep in mind is that every patient who electively chooses to undergo rhinoplasty (nose job) is doing it with hopes of looking better. Typically, in these cases, the nose has some specific feature that is distracting from the overall attractiveness of the face.
For example a nose can appear to be too long, too short, too wide or too thin, but only relative to THAT individuals facial features. The same nose could potentially look perfect on another person’s face. This is where rhinoplasty surgery gets interesting and really demanding. Suddenly it’s no longer about the nose. It’s about the face and the artistic and technical acumen of the surgeon to bring it all together.
The best example of this is with ethnic rhinoplasty. Often, attempts are made to create an ideal nose on a Middle-Eastern, Asian, or African-American patient. But if the “ideal” that is being followed is based on the Caucasian nose, the end result is an unnatural appearance that screams “rhinoplasty.” When this occurs, the disharmony between the nose and the rest of the facial features distracts and detracts from the individual’s overall attractiveness.
Furthermore, I find that the majority of patients are not far from their “individual” ideal, and subtle refinement is all it takes to tone down a harsh hump or gently reduce the width of a nose, etc. Really listening to the patient’s desires and working with the intrinsic anatomy as opposed to trying to totally re-design it are important factors in achieving excellent natural-looking rhinoplasty results.
As a consumer, the first step is to look for a well-trained rhinoplasty specialist. Next, evaluate the before and after photos carefully. Even ask to have the opportunity to visit with previous patients. Then, ask yourself the following questions:
- Do the results look natural?
- Do the faces look more attractive as a result of the change? Although, it seems like it should every time, the reality is, even if the nose looks better, it doesn’t mean the overall look has been enhanced.
- Finally, do the results appear similar to one another? Some surgeons have a signature style or more bluntly.. a cookie-cutter nose that is produced for essentially every case. Often, these noses are not the most natural-appearing… since there is no such thing as a “one size fits all” nose.
How to get a natural looking rhinoplasty result
Rhinoplasty is an operation that has undergone an evolution over the last decade. Patients and surgeons have an increased awareness of natural results. There is also an emphasis on providing stability for long term results, ones that will last 10, 20, 30+ years without developing problems. This is different from traditional surgeries, which used maximal reduction and resection as the means to achieve their results. The consequence of these techniques was an unnatural look with a high risk for long term partial nasal collapse and breathing difficulties.
The situation you describe is quite optimal for a natural-looking result.
- Most of the problems that patients encounter in both healing and operated appearance arise when aggressive tip surgery or overreduction of the profile is performed.
- If you like your tip and it can balance well with a reduced profile, then your likelihood of a natural result is increased.
- Additional benefit can be gained by leaving the bridge of the nose high.
- In some instances, a subtle hint of a bump may be cosmetically pleasing, depending on your overall facial structure.
- At most, a straight (not scooped) profile should be made, which runs just slightly (1-2mm) below your tip defining point, or highest point of the tip when viewed on profile. This optimal transition is medically referred to as a supratip break.
When patients require more extensive tip correction, I believe that several things are critical to ensure a 'natural' result.
I perform almost exlusively closed rhinoplasty, which by definition limits the number of grafts and sutures that can be used to modify the tip. As a consequence, I approach a nose with the mindset of how it can be modified, based on the underlying structure. My goal is not to restructure the nose using multiple grafts, but to remodel the existing cartilages into a different form.
With this in mind, my computer imaging consultation is driven by the concept of remodeling. Other surgeons will image what they want and then figure out how to get there. This often leads to an increase in the number of grafts that are used. Grafts increase a patient's potential for long term complications and may become visible over time as healing progresses. I limit their use to an absolute minimum and typically only require them for deviated nasal corrections or patients seeking a more 'stylized' result.
Translation: Remove only what you must, change only what is required, and ensure that structures will be stable over a long period of time. I believe that retaining and working with the essence of a patient's nose, not striving for radical wholesale change, is what provides a natural result.
Rhinoplasty: Get the right doctor for your nose
In recent years, both doctors and the general public have developed a sophisticated taste for results of rhinoplasty (nose job) surgery. Gone are the days of “smaller” noses, “cute” noses, and “dainty” noses. The most common request in my practice is to have the most natural-looking nose possible – “I want it cute, and natural”.
But what defines “natural” in a rhinoplasty result? What makes one person’s nose look obviously altered by surgical manipulation and another’s elegant, refined, and more balanced with his or her facial features?
Historically, the Egyptians, and Greeks, followed by Rennaisance artists such as Michelangelo, and Da Vinci, have studied countless faces and performed countless cadaver dissections to derive the anatomic features most pleasing the human eye.
In recent times, several of my colleagues have attempted to answer this very question. For example, Drs. David Pearson, and Peter Adamson of Toronto, Canada, published such a study in the Archives of Facial Plastic Surgery in 2004, exploring what type of nasal profile the general public considers most aesthetically pleasing. The study presented digitally enhanced photographs of Caucasian female volunteers in profile view (from the side) with their bridge and tip depicted in five different variations. The bridge was depicted as convex (with a hump), flat, or concave (with a scoop, or slope). The tip variations were depicted as tips that were overprojected (too far forward) to underprojected (too close to the face), and overrotated (pointing up) to ptotic (pointing down). The features that the survey returned were combined in order to draw the most beautiful nose as determined by the study’s participants.
The results of studies such as this are not surprising - a flat to slightly concave bridge, a subtle break or transition between tip and bridge, and a tip angled slightly above the horizontal.
As someone who doesn’t let a nose pass by without formulating a complete analysis and surgical plan, I can tell you that achieving a “natural and beautiful” nasal appearance after surgery is not as easy as studies like these would suggest. This is why there are specialists and so called “dabblers” in rhinoplasty surgery.
If you have been considering rhinoplasty, here are some tips and facts you should know to help you get your ideal result.
Have your own plan:
At the beginning of every consultation, I ask my patients some relevant medical history; then, I ask the patient “what would you do if you were me?” Simply put, what do you think is required to give you a result with which you would be happy? For some, a simple “shaving” or reduction of a hump on the bridge is enough; for others, a narrower tip, less visible nostril skin from the side view, so on and so forth.
In some cases, when the patient does not have a clear view of what they would change in their own, I would recommend using morphing software to digitally enhance and change features of the nose to facilitate discussions of the detailed changes they may and may not experience after rhinoplasty. In this digital age, photos are easily obtained, and reviewing them is extremely helpful in the consultation with your doctor. In fact, some patients notice new things they don’t like about their nose during this part of the consultation.
Whatever it is that you don’t like about your nose, the consultation with your potential surgeon is the time to put it on the table. At this time you should hear a few confirming comments from your surgeon and a plan for how to execute the surgery to fit your needs.
Know what you like:
When it comes time to look at the doctors' before and after pictures, some offices have a patient coordinator or consultant review the pictures with you, while some doctors prefer to review the pictures themselves. Regardless of how it is done, you must see a fair number of before and after pictures from each doctor with whom you consult. If the results you see are not to your liking, don’t have your surgery done there - plain and simple.
Although most rhinoplasty surgeons have a fair knowledge of the aesthetic ideals and know the measurements that comprise this ideal, each person's ideal that they consider beautiful is different. The old cliché “beauty is in the eye of the beholder” holds true in regards to surgical results. If there are any doubts in your mind that your bridge might be too scooped for your liking, or your tip may be to forward, etc. then continue shopping – you owe this much to yourself!
Selecting your Doctor:
The American Board of Medical Specialties, who overlooks all specialty boards, considers diplomates of two specialty boards qualified and capable of performing plastic surgery on the face and nose. These are the American Board of Otolaryngology – Head and Neck Surgery, and the American Board of Plastic and Reconstructive Surgery. Some diplomates of the former are also certified by the American Board of Facial Plastic and Reconstructive Surgery, indicating that they have completed a special examination and review process for competency in Facial Plastic and Reconstructive Surgery.
Despite specialty training, board certification, and membership to professional societies, the real abilities of surgeons are generally determined by many other factors.
One factor you should include in your decision is the doctors overall experience with the nose. Patients have repeatedly asked my staff “how many has he done overall, this year, this month, and this week.” Of course, there are no magic numbers that can be used as a measure for experience, but you wouldn’t want to have surgery in a practice whose specialty is tummy tucks.
In general, for elective procedures, I recommend that patients find a good personality fit for them. You should be comfortable with your doctor, and he or she should be comfortable with you. There should be no embarrassment or hesitation for you to discuss problems with your surgeon. He or she is committed to your best interest, and to getting you the best possible outcome. This requires good communication and overall personal comfort in the doctor-patient relationship.
Know your anatomy:
Prior to consultation with your surgeons, you should have a good knowledge of your nose. Just as you should know what you would do if you were operating on your own nose, you should know if you have had fractures, breathing problems, or possible allergies.
One of my standard questions during a consultation is “which side is harder to breathe through?”. It may be your right side, your left side, or even switch sides. You may not have breathing problems at all.
Because of the anatomy of the nose, its form and function are very closely related. Any change in the appearance of the nose may translate into a change in its function. If you are undergoing elective surgery to improve the appearance of your nose, you deserve your surgeon’s careful consideration of your nasal airway and nasal passages during your surgery. After all, what good is a beautiful nose if you cannot breathe through it?
Know the risks:
As with any other surgery, there are some potential risks associated with rhinoplasty. General risks include bleeding, infection, scarring, and blood clots under the skin. These and other specific risks should be carefully reviewed prior to rhinoplasty surgery. Not to scare you, but to inform you of things you should bring to your doctor’s attention in the post-operative period. These may also help you decide if the changes you are requesting are worth taking the risk to improve. Your surgeon should also honestly discuss the risk-benefit balance of your specific desired outcome during your consultation.
Recovering from rhinoplasty is generally not painful, but can certainly be uncomfortable due to nasal congestion within the first few weeks. Bruises generally resolve within a week, and then there is the swelling. Swelling can mask the true result of your nasal surgery for months. It is generally thought that about eighty percent of your swelling resolves in the first six weeks, and the remaining twenty percent within one year from your surgery. Depending on how you heal, and the thickness of your skin, you should see a nearly complete result by six months from surgery.
Taking the plunge into a surgery that will change the central feature of your face can be relatively stressful, but rhinoplasty is among the most common elective surgeries performed today. The key things to remember in choosing the right surgeon for you will also help you to feel more comfortable trusting your face to your doctor.
Also remember to keep your goals subtle. Dramatic changes can lead to increased risk of an operated appearance, and a nose that is unbalanced with the rest of your face. Train yourself to use the “–er” words like “smaller”, “cuter”, “flatter”, “straighter”, and you will be happier in the end.
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For a natural rhinoplasty result don't get a perfectly straight profile
A bump seen in the profile view is one of the most common concerns we see in patients seeking rhinoplasty. Many wonder about or ask whether they can achieve a perfectly straight-line profile after surgery? You may have seen rhinoplasty results such as these, or those that go one step further and scoop out the nasal bridge.
The fact is that even beautiful unoperated noses are NEVER perfectly straight in profile. You could even say that nature hates a straight line since all of our features are made up of gentle curves and geometric shapes.
Our eyes are drawn to straight lines. We recognize them and pick them out easily. So, a scooped out or perfectly straight nasal profile is usually a dead giveaway that someone has had rhinoplasty surgery. Not only is it unnatural, a ski-slope profile overly softens the nasal appearance, making it appear ‘washed out’ and child-like.
A naturally appealing profile has a very slight fullness or ’strength’ in the area of the bridge and just a hint of a depression or ‘break’ just above the tip. This is the post-operative profile we strive for in our practice for many of our patients. However, we will work with you during your consultation to see what is optimal for you. After all, it's your nose and your aesthetic matters most.
Some patients prefer the idea of a straight profile, which can be very elegant if it fits your other facial features. We rarely have patients who even ask for a slight slope, and that may be OK for them. But, if you want a great-looking and totally inconspicuous Rhinoplasty result, ask us about going ‘natural’.
For a natural-looking rhinoplasty, seek experience, think function
- The best way to think of Rhinoplasty is a procedure of form and function. 80% of breathing is perfomed through the nose. In turn, we warm and humidify the air we breathe through the nose.
- "Old fashioned" Rhinoplasty approaches were primarily reductive procedures, or procedures designed to take away cartilage and soft tissue from the nose. Because of the very important functional role of the nose, overly aggressive nasal procedures cannot only alter your appearance, they can also dramatically alter function.
Normal Function, Natural Result
- More recent trends in Rhinoplasty, termed "Structural Rhinoplasty" as described by Calvin Johnson and Dean Toriumi, promote augmentative approaches to refine the anatomy and appearance of the nose. Rhinoplasty, when performed under this philosophy, tends to yield more natural appearing results.
- It makes sense that more conservative, augmentative procedures will not only preserve function, but will also produce an aesthetically pleasing, natural look.
Not for the Occasional Surgeon: Seek Experience
- It is no secret that Rhinoplasty is one of the most challenging procedures for the best of surgeons. It is also no secret that the appearance of a nose after Rhinoplasty evolves over time and that a nose will show changes from one to five years after the procedure. Experience in Rhinoplasty is a very important ingredient in the selection process of a surgeon.
Todays rhinoplasty is different than your...
Todays rhinoplasty is different than your mother's/grandmother's rhinoplasties. New techniques allow us to obtain results that are far superior to those achieved even 10 years ago. It was possible because contemporary rhinoplasty techniques involve not only removal/resection of the cartilage and bone but also improvement in the structural support.
It is still a very challenging and difficult procedure. There is no substitute for experience. You should carefully select your surgeon and make sure that he is very experienced in performing rhinoplasty surgeries.
Look at the before and after photos. Since most people don't allow their pictures to be shown to the general public, one has to have hundreds if not thousands of patiens to show multiple samples of the surgeon's work.
If the nose surgery is performed right, the nose will appear absolutely normal after surgery.
Natural rhinoplasty? Pick your surgeon carefully!
Rhinoplasty is considered the most difficult of all facial plastic surgical procedures by the best rhinoplasty surgeons in the world. Your best chance at a natural-looking result is at the first surgery.
It is not rhinoplasty that makes a nose appear fake, but the surgeon who operates on the nose. Take your time to do your due diligence about your surgeon’s skill and aesthetic sense. It takes a lot longer to repair a botched rhinoplasty than to choose your surgeon wisely and most carefully. Make sure that you communicate what you want your nose to look like (as well as what you don't want it to look like) to your surgeon, listen to what your surgeon plans to do, and make sure that they are the same (or very close to the same). You need to be on the same wavelength before getting anywhere close to the operating room with your nose.
Choose your surgeon most carefully!
Be well and good.
Harmony, Balance & Proportion are Critical to Fantastic Rhinoplasty Results
Dorsal humps can be easily removed from the nose with preservation of a natural appearance. This can ultimately result in significant improvement in facial aesthetics. This can be accomplished with standard rhinoplasty techniques.
Before proceeding with this type of procedure a careful analysis of facial aesthetics should be undertaken. It’s important to consider the nose in the context of other facial structures. Harmony, balance, and proportion are obviously critical to facial aesthetics. Each patient must be considered individually. It’s important to be evaluated by a board certified plastic surgeon who has experience with rhinoplasty. When appropriate evaluation and surgery are performed, satisfaction rates are high with rhinoplasty.
Rhinoplasty: Tips for Getting A Natural Result
Rhinoplasty is often considered the most diffcult procedure in cosmetic surgery. For the nose to appear natural it must be in balance and harmony with your other facial features.
Here are several tips for increasing the chances that you will get a natural-looking result with your rhinoplasty.
- Choosing a qualified surgeon is the most important decision you can make when deciding to under go nasal surgery.
First and foremost, choose an surgeon who specializes in nasal surgery. Your surgeon should also experienced at correcting both functional problems (such as a deviated septum) and cosmetic problems.
- Your surgeon be Board Certified in either Otolaryngology (ENT) or Plastic & Reconstructive Surgery
Not all ENTs or Plastic Surgeons routinely perform rhinoplasty. It is important to find one who does. Rhinoplasty takes considerable experience to get predictable results.
- View the Surgeons Rhinoplasty Before & After Results.
Most rhinoplasty surgeons maintain a portfolio of examples of their results that compare before and after photos, and many qualified rhinoplasty surgeons have a "Results Gallery" on their websites. You can tell a lot about your potential results by looking at their previous work.
- Ask to See Simulated Results.
Your rhinoplasty surgeon should analyze your pre-operative photographs with you and be able to show you graphically their intended results.
Choose carefully by results -- not marketing
The only way to get a natural-looking result is by looking at many before-and-after results of surgery. Many surgeons write extensively and market with catch-phrases. The 6-12 months-after photos are the only way to tell if you and the doctor have the same interpretation of "natural-looking" results. There should be no scoops, pinched-tips, pig-noses, etc. Furthermore, a surgeon who specializes in Revision Rhinoplasty and has a great deal of experience will be more likely to achieve a good result -- you won't be participating in the learning curve.
My before-and-after photos demonstrate how subtle changes provide a natural appearance after rhinoplasty.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.