I'm a 25 year old girl and feel that my nose is too wide and bulbous. I have a short nose and the part where my nose meets my forehead is very low. I want to make my nose narrower and higher(where it meets my forehead), maybe longer (Is it even possible?). Can all these concerns be addressed with a single rhinoplasty surgery? What procedures would it involve? Also whenever I smile, my nose takes on a very different shape with the middle part pointing downwards. Can this be corrected?
Rhinoplasty for Short and Wide Nose?
Doctor Answers (18)
Rhinoplasty for droopy tip and wide nose
Dear Rhinoplasty patient,
Reviewing your pictures, I would recommend a reduction rhinoplasty and tip refinement for you. This reduction procedure can help to reduce a long nasal tip, a bulbous tip, and large hump or all of them in combination. An experienced rhinoplasty surgeon will consider these complex nasal structures and will modify them in proportion to create a natural looking nose.
Short Wide Nose-Tip Rhinoplasty wit Narrowing of Bones Best Option
Thank you for your question.
First, I would say that you side view is excellent and I would be very cautious about changing it. You have a nice straight nasal profile with good tip projection. Trying to "fill in" the area near your forehead could cause a deformity.
A Tip Rhinoplasty can narrow your nasal tip but you will also need narrowing of the nasal bones to keep the front view in harmony.
BE AWARE-you do have a slightly twisted or crooked tip-probably caused by a curve in your Nasal Septum. This must be addressed and corrected or the crooked appearance could be worse after surgery
Yes, it can be done in one procedure
The pictures you presented are good and you concerns can be addressed with open rhinoplasty. For the bridge; elevating it with a diced cartilage graft will not only improve the shape but will also improve the length. For the tip; a tipplasty with cartilage suturing techniques will improve the width and the height. As for the nasal tip depression during smiling; a release of the muscle the pulls the tip downward will correct this problem. I hope this is helpful.
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Rhinoplasty for short, wide nose
The rhinoplasty procedure can address augmenting the radix or glabella with either the patient’s own natural tissues, such as cartilage from the internal portion of the nose, or a synthetic silastic implant. The tip droop that is occurring from the depressor septi muscle can be released. The tip can be tilted slightly upwards through some tip suturing techniques as well. This will also refine the width of the tip. Osteotomies are performed to narrow the nasal bones along with the upper lateral cartilages that are connected to the bones.
To do photo imaging with your own photo, download our iPhone app free of charge. Just enter "Seattle Plastic Surgery with Dr. Portuese" as search terms. Once downloaded, you can simulate rhinoplasty by changing the shape of your nose to be smaller, larger, etc...
Rhinoplasty for short and wide nose
The concerns you have about your nose: the tip pointing downward with smiling, the nose being too wide and bulbous, and the area where your nose meets your forehead being too low, can all be addressed with rhinoplasty. The tip can be supported and upwardly rotated with a columellar strut graft and by weakening the depressor septi muscles. The bulbosity of tip can be addressed with cartilage suturing techniques and/or a cartilage tip graft. The nasal soft tissue covering can also be thinned to further decrease the fullness of the tip. A radix graft preferably with crushed septal cartilage or ear cartilage can be used to decrease the angle between your forehead and your nose and lengthen the nose. Hope this helps, good luck! :)
Short Nose Rhinoplasty
Thank you for sharing your photographs. I agree with Dr. Westreich. Your results may be achieved with augmenting the bridge, which is typically performed with cartilage. Cutting the muscle that droops the tip would also be performed. Nostril narrowing will require small incisions at the base of the nose to remove excess skin. All of these procedure can be performed via an endonasal rhinoplasty or open rhinoplasty.
Only after a comprehensive evalaution can a rhinoplasty specialist help determine appropriate options for you. Best of luck.
Rhinoplasty Changes and Dynamic Issues
The situation you present is not an unusual one. Your concerns can essentially be grouped into the following:
LENGTH: Making a nose longer can be accomplished with grafts. Depending on the nose, you either add length by derotating the tip, augmenting the bridge (as you showed) or adding a 'precrural' graft to the columella. Since your columella is not retracted, I agree with the photos that you showed on the site. Your tip is not over-rotated, so derotation does not make sense. The best choice for you would be to add a 'radix graft' and add some height. This will produce the illusion of additional length.
WIDTH: Adding height will make the nose look narrower. Osteotomies to narrow the nasal bones will also do this. Suture Tip-plasty techniques can narrow the tip, so it balances with the new, narrower, upper nose.
DYNAMIC TIP PTOSIS: When you smile, 2 things happen: The cheeks rise up and then nasal tip goes down. When the cheeks elevate, the nostrils are pulled upwards. There is nothing that can be done to address this problem other than not smiling. Conversely, the tip being pulled down is a reversible problem. Cutting the depressor septi muscle will eliminate this part and lessen the issue that you desrcibe.
Hope this Helps and Best of Luck
Bridge Augmentation and Tip Narrowing Possible
Hello and thank you for including your photos.
Bridge Augmentation: Your imaged photos showing two degrees of change to your bridge are well done and it is possible to achieve that kind of augmentation with surgery. There are various materials for bridge augmentation including your own cartilage or a Gore-tex implant.
Tip Profile View: At rest, I think your tip position on profile looks perfect. Much of the angle change that you see when you smile is related to your facial muscles pulling the base of your nostrils upward, giving the illusion that your tip is changing. Unfortunately it is not possible to modify those particular muscles as that would affect your ability to smile.
Tip Front View: I personally think your tip on front view looks good. However, if you wanted it to be more narrow this could be achieved by reshaping your tip cartilages.
In summary, it would be possible in one rhinoplasty surgery to augment your bridge and narrow your tip, but it is not possible to stop your tip from changing when you smile.
Rhinoplasty for Short and Wide Nose
Yes, it is possible for all of your issues to be corrected in one surgery. Augmenting the dorsum can help improve the angle at which your nose meets your forehead. This can be achieved using your own cartilage. The nose will appear longer following this procedure. Your tip may be brought up as well, which will result in less of a droop when you smile. Thank you, and I hope this helps answer your questions.
Rhinoplasty, Nasal Surgery, revision Rhinoplasty.
Yes, you could build up the bridge of your nose, thin the nasal bones and tip cartilages. The tip appears, from your photos, to be rotated at approximately 110 degrees from the upper lip which is the proper aesthetic angle for a female nasal tip...so I don't believe that it needs to be lengthened (another way to say the nasal tip is rotated downward at 100 degrees or less).
All of this could be done with a single closed Rhinoplasty. An open Rhinoplasty IMHO would allow your nasal tip to rotate upward an additional 5 degrees which would look unsightly and the nose to short.