Dear Mdelaro, You are an excellent rhinoplasty/septorhinoplasty candidate and your concerns would be addressed during surgery allowing you a more refined nose with a natural looking appearance. During consultation digital imaging can be used to show you the proposed changes and and then your surgeon will discuss the surgical procedures needed to attain the proposed result. After direct examination your surgeon may decide you need a septorhinoplasty which is a combined procedure. The "septo" portion addressing the septum and the functional aspects of the nose. The "rhinoplasty" portion addressing the aesthetic aspects. It is important that your final result is a natural looking nose that fits your facial aesthetics and a functioning nose to improve your breathing difficulties.
You are an excellent candidate for rhinoplasty surgery and I agree with your critique. I have used both open and closed procedures for many years; having said that, years ago there were only 4 of us in the United States who were big advocates of the open procedure. However, yours could be done either way. After an examination I would describe the advantages and disadvantages of each for you.
Yes, you are a good candidate to have a closed rhinoplasty procedure. To reduce the bulbous tip, suture techniques are applied to the lower lateral cartilages to narrow the tip. The dorsal hump which is composed of both bone and cartilage can be shaved down. Osteotomies of the nasal bones will help straighten and narrow them as well. The concave upper lateral cartilage in the mid-vault area on the left side will require a spreader graft placement. Releasing of the depressor septi ligament will prevent the tip from drooping when smiling. For many examples, please see our closed rhinoplasty photo gallery
Your nose can be improved with rhinoplasty. A closed approach should help you achieve your nasal aesthetic goals. Your most important task will be to choose your rhinoplasty surgeon most carefully. Good luck and be well.
Excellent cosmetic results can be achieved
with both techniques. There is not a best way to perform the procedure.
Individual surgeons have their own preferences of how to produce the best
results in their hands. What is more important than whether a closed or open
approach is utilized is the experience and artistry of the plastic surgeon and
your comfort level and confidence in that individual.
Following the advice from a surgeon on
this or any other website who proposes to tell you exactly what to do based on
limited 2 dimensional photos without examining you, physically feeling the
tissue, assessing your desired outcome, taking a full medical history, and
discussing the pros and cons of the operative procedure would not be in your
best interest. I would suggest you find a plastic surgeon with extensive nasal
surgery experience who is certified by the American Board of Plastic Surgery
and ideally a member of the American Society for Aesthetic Plastic Surgery
(ASAPS) or a facial plastic surgeon that you trust and are comfortable with.
You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
Thank you for the the pictures and the question. We have tremendous experience dealing with droopy tips and we would tell you that open rhinoplasty provides a more controlled and accurate deprojection of the nose. Moreover, an open approach will allow your surgeon to better determine why your nose is indented on the left side and how to fix it in a way to alleviate your breathing, while often times closed approach often allows the surgeon only the ability to camouflage the problem with grafts.
In general, based on the picture we would say you should have an excellent result and should find a rhinoplasty specialist who can achieve the goals you have in the most precise and long lasting way.
All the best,
Peyman Solieman, MD
All of the things you have stated are reasonable and can be fixed by rhinoplasty. Whether it is done by open or closed technique is entirely up to the surgeon, his training and experience. Either approach would work equally well for you. Get more than one opinion and go with the one you feel comfortable with. Good luck.
You are a good candidate for a rhinoplasty and should be able to obtain the desired result. Go on consults with specialists who will take your photo digitally and then alter it with your input till you see the result you are looking for then ask him how he will accomplish it. That way you will know what possibly can and cannot be accomplished
Tip refinement with overall size reduction can be achieved with a closed approach. Find a rhinoplasty expert who creates natural results.
Kenneth Hughes, MD
Los Angeles, CA
Rhinoplasty for the droopy convex nose consists of conservative hump removal and tip refinement along with slight elevation of the tip. Choose an experienced rhinoplasty surgeon who does natural noses.