I Want a Smaller Nose, but Rhinoplasty Surgeons Suggest Only Minor Changes?

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 refined sculpting of the supporting framework may be hidden, and the results disappointing. In cases of reduction rhinoplasty, you have to be careful of how much the framework is reduced,... more

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 nose to the face as a whole. With this in mind, just making the nose smaller or shorter may take away from the overall shape of the nose and its relationship to the face. The bottom... more

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 proportion of the rest of the face--are other considerations. Here's a helpful tip, I think: consider a rhinoplasty consultation as if you're commissioning a piece of sculpture. By that I... more

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 that putting a nose back into such a harmonious relationship with the rest of the face is often more attractive than creating a “new” nose. There are anatomic restrictions... more

Dottie, it is difficult to give an accurate response to this question without at least seeing what your nose looks like. One possibility is that the second rhinoplasty surgeon you consulted with simply did not feel that your nose would benefit from additional reshaping. Another scenario is that your skin is relatively thick. If this is the case, it is unlikely that the surgeon could make the nose significantly smaller without risking a lack of definition in the final result. If the... more

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 one to see which two suggest the similar treatment.

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 be further reduced in size without causing collapse of the nose You may have internal nasal problems such as septal deviation and nasal valve collapse which would put you at more risk... more

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 these patients to accept a conservative and natural change in their nose. Certainly, you should seek multiple opinions but if other well-qualified doctors are telling you the same thing, please... more

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 your nose as it relates to your face as a whole. Your hair style, makeup application and seasonal skin coloration may also affect your perception of the size of your nose. These issues... more