I'm 48 and I have always HATED my profile and my "ski slope" nose - the bottom/nostrils are pushed up at what seems like a crazy angle pulling up the skin between the nose and the lip and makes my nose look like a ski slope!. Hate my profile but I don't mind how I look in most photos taken straight on. Would you advise a nose job or is this just in my mind?
Rhinoplasty An Option? (photo)
Doctor Answers (12)
Rhinoplasty An Option?
Rhinoplasty is really the only way to address a rotated, high tip. The tip can be lowered to create a smaller nasolabial angle. Kenneth Hughes, MD Los Angeles, CA
Rhinoplasty an Option?
I agree with your concerns about your nose. Your nose can be de-rotated, increasing the nasal length, with a cartilage graft and the top of your bridge augmented. For the bridge I would use diced cartilage in a sheath of fascia. Consult with an experienced surgeon who can provide a natural non-surgical appearance.
Rhinoplasty for Downward Tip Rotation
I think your historic perception of your nose does have a basis in reality. You do have a very open nasolabial angle with relatively significant tip rotation, thus creating your profile concerns. Rhinoplasty can be very effective at building up the bridge and, most importantly, dropping down the tip of the nose. Deprojecting the nose is technically challenging and requires cartilage grafting to do so. But in a previously unoperated nose like yours, you have an ample septal harvest site to do it.
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Rhinoplastyis definitely an option
You have a short nose with a low radix and tip that is very rotated relative to your upper lip. Your nasolabial angle looks like it's at least 120 degrees. You can certainly have your tip derotated, nose lengthened and bridge raised to improve your profile. You should definitely have a consult with computer imaging so you can see if any or all of these changes would give you the look you want and make you feel better. This way you would know what was going to happen beforehand.
Correcting a ski slope type nasal dorsum
There several features notable on your nasal profile that can be altered to change the contour of your nose. You have two prominent features, an overly projected nasal tip and a low radix. The radix is the most inward portion of you nose between your eyebrows. I believe that you have a low radix, it should be at the level of the crease of your upper eyelid. By having a low radix it accentuates the ski slope effect of your dorsal profile. The same is true for your overly porjected nasal tip. Computer imaging would be a valuable tool to assist you and your surgeon to the features you want to improve. The nasal tip can be pushed back and derotated and a graft can be placed to raise the radix.
Video imaging is a good way to decide what you want from a rhinoplasty and if it is able to be accomplished.
Any nose can be changed in appearance. Whether or not the desired endpoint can be created in the operating room is another matter. I use video imaging to learn with the patient has in mind and then determine whether I can deliver that in the operating room.
Blocking out your eyes in your posted photos does little to hide your identity but does make it harder to evaluate the photos. I am not so sure you have a ski slope but the tip is definitely turned up to about a 110 degree angle and the bridge looks short for your facial proportions. The nasal spine is contributing to this by pushing the upper lip-nose junction outward. Something as simple as removing the spine may give you most of what you are looking for. You could add a graft to the bridge to lengthen it at your discretion.
You should consider a chin implant to balance out your lower face with your midface which could be done at the same time, a later time or not at all, as you wish.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.
Rhinoplasty is Best Option for Correction of "Ski-Slope" Nose
Since you feel so strongly about the appearance of your nose, you should consult with a few rhinoplasty surgeons and discuss your concerns. The angle at which your nose projects from your lip should be decreased which will help you achieve your goals. Choose your rhinoplasty surgeon most carefully. Good luck and be well.
Rhinoplasty An Option?
Noe that is how to post photos! I might suggest trying a non surgical rhinoplasty, that is fillers to the bridge area, etc. Before seeking an operative correction.
Rhinoplasty for "Ski Slope" Nose
Based on your pictures, a rhinoplasty can improve the side view of your nose and rotate the tip down a bit.
It would be good to see a local Board Certified plastic surgeon or facial plastic surgeon for a formal opinion.