Rhinoplasty - I want a smaller nose. Why do rhinoplasty surgeons suggest only minor changes?

I have been told by one surgeon that if I had nose surgery that he could only make a small change to it. Should I get a second opinion? I have already seen a surgeon elsewhere and liked what he suggested could be done but, I would like it also to be a little smaller. He says that this isn't possible. He says my nose really does not have very much that would be considered abnormal but, I think it is too big.

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8 answers to “Rhinoplasty - I want a smaller nose....”

A: What you want for Rhinoplasty may not be the best

Steven Wallach, MD

Rhinoplasty is an art. It is hard to tell you what to do without seeing your photos and/or examining you. You will always find a surgeon who will tell you what you want to hear, but it may not always be the correct thing to do. If they have very diffferent opinions, then I would possibly conside seeing a third... more

A: Commissioning a piece of sculpture

David C. Pearson, MD

As my colleagues have mentioned, there are many reasons why someone's nose cannot or should not be made as small as they'd want. Skin thickness and cartilage strength are two of the primary structural reasons that may limit the amount of change possible. Aesthetic considerations--how the nose would look in... more

A: Smaller doesn't always mean Better

Sam Naficy, MD

In rhinoplasty shape matters more than size. Experienced rhinoplasty surgeons may promise you a more subtle change in size for a number of reasons: You may have thick skin which will limit the degree of size reduction as it will not conform to a smaller size framework You may have weak cartilages that cannot... more

A: First of all, there's certainly nothing wrong with a...

Shahram Salemy, MD

First of all, there's certainly nothing wrong with a second opinion, as it's always important to find a surgeon that you are comfortable with. When it comes to rhinoplasty, smaller does not necessarily equal better. The key is to balance not only the aesthetic units of the nose with each other but also the... more

A: It is very often the case that patients dislike their...

Richard P. Rand, MD

It is very often the case that patients dislike their noses more than they should and percieve problems with them that are really very minimal.  They will frequently say "I've always hated my nose!"  In these cases, the surgeon should be very honest and try to redirect the expectations of... more

A: Do what is necessary and nothing more

Jeffrey D. Hoefflin, MD

Plastic surgeons often discuss with their patients maintaining their “facial harmony” when exploring various rhinoplasty options. By this, it’s important to consider maintaining the overall symmetry and proportion of your nose with the rest of your facial characteristics. It is my opinion... more

A: A thorough evaluation of your nose will place the size...

Scott Sattler, MD

A thorough evaluation of your nose will place the size and shape of the nose in the context of the other features of your face. It may be that your nose does 'fit' your face, but that your attention is directed only to your nose. I would suggest asking your plastic surgeon to comment on the size and shape of... more

A: Getting what you want vs. what is possible...

Michael A. Bogdan, MD

Without actually examining you, it is difficult to completely answer your questions. To change the shape of your nose, the supporting framework of bone and cartilage is modified, and the overlying skin re-draped. The skin plays a vital role in the final result – if it is very thick, even the most... more

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