I have gone to a consultation for rhinoplasty on my nose.. My main problems are that I have a large tip and flared nostrils.. My side profile is straight so that doesnt concern me However the surgeon suggested that he will just reduce the tip and not worry about the nostrils as it will create a "pinched" look.. But I think I might need the nostril base narrows as my narrows are quite big Do you have any suggestions?
Second Opinion for a Bulbous Tip? (photo)
Doctor Answers (17)
Web reference: http://www.michaelelammd.com
Recommendation for bulbous tip
A bulbous tip can certainly be reduced by tip suturing techniques as well as cartilage removal with a combination of cartilage removal in the nasal tip. This will feminize and refine the nasal tip to be more in balance with the bridge. Alarplasty excisions of excess skin at the base of the nostrils can be performed if the nostrils are too wide.
Web reference: http://seattlefacial.com
Treatment of Bulbous Nasal Tip
The tip can be reduced and definition improved. With the single picture you sent, it is difficult to determine if the base of your nose should also be narrowed. This can be achieved without pinching the tip or causing nostril retraction when done by an experienced surgeon. A more complete set of nasal pictures would help us be more specific in our recommendations. Go to my website for instructions on the submission of photographs.
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Second Opinion for a Bulbous Tip? (photo)
Based ONLY upon the posted photo I recommend seeing rhinoplasty PS in person for a full examination. My guess is a tip rhinoplasty with wedge excisions.
Rhinoplasty can correct a bulbous tip.
Rhinoplasty can correct a bulbous tip and I think that you are an adequate candidate and should expect a very reasonable improvement.
Unfortunately with the block over your eyes I cannot comment on whether your nostrils need to be narrowed because the landmark most surgeons use to determine this is the width between your eyes.
Bulbous nose tip and flared nostrils
From what I can see in the single photo, you are absolutely correct. Your nostrils (alar base) are wide relative to your mouth and rest of the nose. They would be in better balance when made less wide. If only the bulbousness of of the tip is addressed, then the more refined tip will make the nostrils appear even more flared. They both need to be addressed at the same time for a good outcome.
Tip rhinoplasty surgery
From the picture, there seems to be some bulbosity which needs to be addressed. I think a conservative refinement would yield the best result. I would not overdo it. Because we can see your face only partially on this photo it is difficult to assess your nose in the context of your entire face. Therefore, I would tend to approach the nostrils in a conservative way. I would leave them for now and reassess after a few months following tip refinement. Good Luck.
Alar reduction or not?
Second opinion for tip
It's hard to offer advice without seeing your entire face. Many aesthetic "norms' would say that if your nostrils are within your intercanthal distance (lie between the inner corners of your eyes) then they do not need to narrowed. This however needs to be interpreted in context or nostril sill width, flare and your own goals. I would recommend you have some computer imaging to see how it would look either way. When I feel strongly about not doing it I will advise the patient to have tip shaping only initially and let us reassess at 6 months. It is simple to do nostril narrowing in the office under local anesthesia as a second step if still desired. I do not charge extra for this when it is part of the initial plan and there is minimal down time. This doesn't burn any bridges. Nostril narrowing is an irreversible step so be certain if your doctor is advising against it.
It is difficult to say exactly what you will need without an in-office exam. However, narrowing your alar base with internal incisions might be helpful. Make sure you surgeon is boarded in Facial Plastic surgery.
Web reference: http://www.facialinstitute.com
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.