Hello doctors, I am trying to figure out the best way to go about getting a rhinoplasty done. What should be done to achieve the result that I am aiming for? (smaller size, raised tip, narrower nostrils [not a pinched look]) I feel that these are my top concerns: 1. wider nostrils 2. tip is droopy 3. it is too big, and it draws from my other features. I've heard all of the following, "minimize the nostrils," "lift the tip," and the last one said I needed a "tip graft." I appreciate your help.
What Should Be Done to my Nose to Achieve a Similar Result? (Rhinoplasty)
Doctor Answers (14)
I can answer part of your question with confidence. Do not get a cartilage tip graft in your case. Reduction of the nostrils can be done with cutting out a wedge of skin where the nostril meets the cheeks. This is referred to as an alar wedge excision. The most important factor in getting a good result in rhinoplasty is selection of the right surgeon who has the experience and can show you many cases that you like.
Realistic range of expectations
You're a great candidate and a pretty straightforward patient in terms of what can be done. Reducing the hump can give you the profile you want along with sculpting the lower lateral cartilages and using internal construction sutures to define, support and reposition ("lift") the tip to where you like it. I would not use a tip graft to get the result you want and in fact I'd avoid that in someone with skin that appears as thin as yours since they often show through and look odd. Osteotomy and infracture will be necessary to prevent an open roof deformity in most cases with that much reduction but you have a very narrow nose and I'd bet that after I examined you we would discuss internal spreader grafts as an alternative. I would perform Wier wedge excisions on your nostrils very conservatively to just minimize the flare but avoid over reduction or "pinching" the nostrils. The variables the require that every rhinoplasty patient accept a bit of a range of outcome include callus formation at the site of the bones healing back together and the amount of scar tissue your body deposits under the skin as it adheres to the newly shaped underlying bone and cartilage. These should be discussed by your doctor during the consultation. Best of luck. Ask to see as many picture of your surgeons work as possible, this is the ultimate artists procedure in our field!
I'm sorry you did not find a surgeon who agreed with your goals for rhinoplasty surgery. I suggest you consult with other specialists, show them the morphed results, and look at their patients who pre-operatively had noses similar to yours. Your computer generated appearance is quite clear.
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hlscii, you would benefit from a properly done rhinoplasty and yes you can achieve the look you desire. You simply need to find the right facial aesthetic specialist who feels they can produce this result. For someone like me who has 25 years experience and has performed hundreds of these procedures this would not be a daunting task. So look in your area and find at least two physicians who have experience and expertise and look at their photos. Interview them and go with someone who makes you feel confident in their abilities. By the way, I prefer not to alter the shape of the nostril at the time of the original rhinoplasty. I wait until the tip has settled and presented itself to the point that I feel comfortable taking this step. Why do I stage this? First of all it is not reversible so if one takes this step it must be done as precisely as possible. Secondly, when I change the projection, orientation and shape of the nasal tip it will change the shape of the nostril in a way that is unpredictable which harkens back to my first point. Finally it is a patient friendly step, can easily be done under straight local, with minimal bruising, swelling and post op discomfort.
What Should Be Done to my Nose to Achieve a Similar Result?
You have to understand predicting final outcomes is an ART not a science! Using computer generated impression results can only confuse you more. Look at photographic examples of the surgeon's rhinoplasties than decide upon the whether you "trust" the surgeon or not. You know the leap of faith" issue.
Redesing your profile
First of all you have to beware of the complication. It could be worst.
So if you agree with that then let`s look at it. There is small hump on the bridge, small depression in the supratip area and the tip could be slight cuter but still natural. It would be great to know your nasal septum location beacuse the supratip break and wider tip could come from the curving septum.
So far this is my advice and let your surgeon look in inside your nose to see the septum.
I hope this will give some idea.
Rhinoplasty for nostril reduction and droopy tip
A rhinoplasty would involve shaving down the hump, slightly lifting the tip, conservatively narrowing the nostrils, and releasing the depressor septi ligament in the tip which makes the tip droopy upon animation. Spreader grafts will most likely be required to prevent collapse of the mid vault of the nose. Please see the link below to our rhinoplasty photo gallery
Remember that computer imaging can not give you the exact result that you might want. But it is worthwhile to show your surgeon the images that you might like so that he/she can work to try to achieve that for you.
Planning a rhinoplasty
There are many features that can be incorporated when planning a rhinoplasty. Your nasal tip appears to be under projected and you have a dorsal nasal hump. While a physical examination would be necessary to plan a complete surgery and predictable outcome I would begin with a refinement of the nasal tip most likely using a cartilage graft and a lowering of the nasal dorsum.
What Should Be Done to My Nose? #nosejob
The first thing you need is a board certified surgeon who loves and specializes at this procedure. There are so many things that can be done. Just glancing at your photos I do think that a hump reduction and tip rotation upward would help your overall aesthetics to your nose. There are also a host of other little things that would need to be done with cartilage grafts depending on what you want. This is why you need a skilled surgeon who understands the nose so they can guide you through the operation and explain all the little cartilage grafts that can be used for nostril rim support and contouring and for tip reshaping.