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Do I Need a Rhinoplasty with a Chin Implant, Nostril Reduction and Nasal Spine Removal? (photo)

asked 7 months ago by thathoustonguy in Houston, TX
Latest answer by Francis R. Palmer, III, MD
Question viewed 390 times
Tags: chin, nostrils, candidate

I have had various opinions and can't figure out what to do. Based on my profile, which of the following might I need? * Chin implant * Nasal spine (bone) removed (mine is large) * Nostril reduction The reason I say nostril reduction is since my nose will get pushed back, I don't want the nostrils to flare and get wide. One doctor said removing the spine would cause problems. One said remove it. One didn't know you could. Please help! I don't know what to do. Thanks!

17 answers to Do I Need a Rhinoplasty with a Chin Implant, Nostril Reduction and Nasal Spine Removal? (photo)

Rhinoplasty and chin.

Your nose is overprojected and it can be set back and part of the spine removed,etc. your chin is fine unless you like a very prominent chin. You need to see a more experienced surgeon than you have seen. Computer imaging does not show you what the surgeon can do. Look at his live patients!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Do I Need a Rhinoplasty with a Chin Implant, Nostril Reduction and Nasal Spine Removal?

IMHO, from the photos provided, your nasal tip is over-projected with columellar show, wide nasal tip and a slight dorsal hump of both cartilage and bone. The chin is a bit weak as seen on the profile view. Rhinoplasty and a chin implant would be able to address all of these issue, however...IMO, it's very important that the angle of tip rotation not be increased in your particular case. Be sure that your Rhinoplasty Suirgeon understands and follows the proper... more

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Rhinoplasty, chin implant, nostril reduction and nasal spine removal

Removing a portion of the nasal spine can be performed quite easily through a closed rhinoplasty. Trimming the caudal septum will also reduce the columellar show. Nostril reduction is only done at the very end of the operation and it really depends upon how flared the nostrils are after the procedure is completed. Look for a very experienced rhinoplasty surgeon to get the results that you are looking for.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Do I Need a Rhinoplasty with a Chin Implant, Nostril Reduction and Nasal Spine Removal? (

Your nose is considered a ' tension nose' which is due to over growth of the septum. Yes, you do need to have the nasal spine removed, lower the dorsum and possibly use spreader grafts as well as alar reduction which can be determined intraoperatively after above procedures.

Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon

You nose is long and this is tenting the tip

It appears that your nose is long. This is because the septum (cartilage between the two sides of the nose) is long and possibly the cartilage that forms the tip of your nose may be long also. By shaving back the end of the septum and removing some of the overlying nasal tip cartilage, your nose will shorten. It will also raise the tip ,which looks slightly droopy. As far as the nostrils are concerned, they probably won't change shape significantly with nasal shortening. I usually make... more

Joseph M. Perlman, MD
Houston Plastic Surgeon

Nasal spine removal and chin implant during rhinoplasty

From the limited photos submitted deprojecting your tip would help bring your nose in better balance with the rest of your face. You have an elongated septum that has created a short, tethered upper lip and excess columellar show. These issues can all be addressed by an experienced rhinoplasty surgeon. If your septum is straight one can perform a tongue in groove setback of your nasal tip cartilages to help stabilize your tip while at the same time addressing your concerns. Whether... more

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

Nasal Reduction with Rhinoplasty

The most important thing you should do is consult with surgeons who specialize in rhinoplasty surgery. On the basis of the pictures I suggest you decrease your tip projection and reduce the nasal spine. Without seeing the base of your nose I cannot tell if the nostrils should be reduced, but this will probably be necessary and is something that you and your surgeon will consider before surgery. I do not recommend a chin implant.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Do I need a chin implant?

You need a consult with computer imaging. You have a very overprotected nose which may have an enlarged nasal spine. It gives you the illusion of a weak chin and shallow radix. Seeing different versions with computer morphing will help you understand the interrelationships and effects of various changes such as chin implant, radix augmentation, nasal spine reduction. Your nostrils will flare and likely need to be reduced.

Michael L. Schwartz, MD
West Palm Beach Plastic Surgeon

www.palmbeachface.com

Nasal surgery

Rhinoplasty can achieve different results for different people. The photos are helpful to get a general idea about what to offer, but an in person exam is essential to really evlauate you properly. Unless you want a very strong chin, I think you chin is ok. There are seveal different manuevers that can help the tip, nostril, alar base relationship but again I would suggest seeing a doctor to review them in person.

Steven Wallach, MD
Manhattan Plastic Surgeon

Rhinoplasty with chin implant

In order to help you with your decision I think it would be beneficial for you to visit with a physician or 2 who can perform video imagining. This will give you and your physician an idea of what you are looking for and help guide the physician to make the appropriate changes. It is the most accurate way to see what all those changes would look like and give the physician a goal to obtain. All of the procedures you ask about seem appropriate from the profile picture, but... more

Robert M. Jensen, MD
Medford Plastic Surgeon

Rhinoplasty struts and grafts

Your photos show a prominent columella with a tethered upper lip and long front to back nasal tip to cheek distance. It is hard to know what would be best without a face to face examination but reduction of the forward tip projection, removal of the anterior nasal spine, reduction of the lower end of the septal cartilage and dividing the upper lip to nose muscle may suffice. I hope you realize that this format of posting questions and receiving answers lacks the face to face direct... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Rhinoplastywith potential chin agmentation.

A computer image would give you an idea what a chin augmntation would accomplish. You could look at the image and decide if it would be something you would consider. There are number of possibilites for your nose. A full set of photographs along witha physical examination would be required to define an operative plan.A computer image would give you an idea of the changes the various manuvers would accomplish. You have a complex nose and should see a board certified plastic surgeon who... more

Jay M. Pensler, MD
Chicago Plastic Surgeon

www.plasticsurg.org

Rhinoplasy and Chin Implant

Of course, nothing will take the place of an in-person examination with a Board-Certified Facial Plastic Surgeon. Also, I can't really assess the nostrils with the photos given. However, a chin implant and a nasal reduction would enhance the side profile. I have been doing nasal spine reductions on appropriate patients for 20 years with uniformly good results. I have never seen a poor result from doing this. You are certainly a candidate for this. Good luck. more

David Alessi, MD
Beverly Hills Facial Plastic Surgeon

Opinion on rhinoplasty

Formal recommendations can only be made after a consultation but based on the photo you submitted, most rhinoplasty surgeons would agree that a chin implant, dorsal and tip reduction , spine resection and alar base narrowing is indicated. That being said, photo imaging would best assess what you want. NO matter what we recommend, a successful rhinoplasty operation is defined as a happy patient and that can only happen if the surgeon and the patient have a unified vision of... more

Philip Miller, MD
New York Facial Plastic Surgeon

www.drphilipmiller.com

Rhinoplasty with chin implant and nasal reduction questions

My expert opinion is that all three would probably be a good surgical plan for you however the weirs or narrowing of the nostrils is best determined during the surgical procedure. would suggest a computer analysis which I use in my consulting patients to show each specific procedure and the aesthetic enhancements that would be obtained prior to the surgical procedure. This helps you the patient understand the medical terminology of the procedures and how they relate to you personally.... more

Michael Elam, MD
Orange County Facial Plastic Surgeon

What to do?

Certainly there is no replacement for a good consultation with an experienced rhinoplasty surgeon. That being said in my opinion there are numerous issue with your nose that should be addressed. The dorsum, or bridge, should be lowered. However the amount it should be lowered is relative to the rest of your nose and you might benefit from adding a graft at the root, or radix, of the nose. I do think that the nasal spine, and at the very least, the caudal septum need to be recessed. Your tip... more

Ronald Schuster, MD
Baltimore Plastic Surgeon

How to improve my nose?

You have done all of the correct preparatory measures: Several consults with good surgeons, carefully paying attention to become an educated patient, and due consideration of available options. However, because you are not the surgeon, you are not supposed to know what to do. Even I cannot tell exactly what to do from the photos submitted. My recommendation however, is to carefully examine the pre and post op photos of the surgeons you're considering. After... more