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Based on simple pictures alone, you need a dorsal hump takedown, osteotomies and tip work but you already have alar retraction (seeing too much into the nostrils) and its very easy for an average plastic surgeon to make that worse during tip work so please find a specialist who deals with all kinds of noses on a daily basis.
You have several factors affecting your nasal appearence, most can be improved
1) dorsal nasal hump, yours appears to be fairly prominent consisting of both cartilageonus and bony components. This makes your radix appear low, but i don't think it will be necessary to ad a radix graft, once your dorsum is reduce it should look more harmoniou8s
2) bulbous nasal tip, this can be corrected by trimming the cartilage and performing tip sutures
3) Nostril shape, this is the most difficult to correct, and probably can not be fully corrected. I could be improved by adding some small grafts here
4) crooked nose, this as well is difficult to completely correct, but yours is not that crroked, so I wouldn't worry too much about it. the nasal fractures, spreader grafts and septal harves shoud help straigthen the nose.
What is the level of difficulty for fixing my nose? What are some terms that describe the problem areas.
The only thing that adds a bit of complexity is the nostril apex disparity with greater retraction on one side combined with columellar show. Both need to be changed to improve the appearance. The other elements are more straightforward. I think your requests are reasonable and can be performed with a closed rhinoplasty.
Find a board certified plastic surgeon who performs hundreds
of rhinoplasties and rhinoplasty revisions each year. Then look at the
plastic surgeon's website before and after photo galleries to get a
sense of who can deliver the results.
Kenneth Hughes, MD
Los Angeles, CA
Rhinoplasty for bump removal and crooked nose repair
There are several issues to concern yourself with this nose when seeking out a rhinoplasty consultation. Look for a very experienced rhinoplasty specialist for best results.
The dorsal hump his composed of the bone and cartilage and would be shaved down.
Medial and lateral osteotomies of the nasal bones will need to be performed to narrow and straighten bridge line once the hump is removed.
Tip surgery may be required which could include a simple removal of the cephalic trim of the lower lateral cartilages, or a suture technique to the lower lateral cartilages.
A very small glabellar graft may also be required at to add height to the bridge
Small amount of columellar show also need to be trimmed back to prevent more columellar show once the hump has been removed
Difficulty of rhinoplasty
You have beautiful features that could be brought out with a properly performed rhinoplasty. From the photos, I can tell that you have a low radix (upper starting point of the nose) with a convexity to the bridge. Nostril arching is due to upward pointing of the cartilages in the nasal sidewalls. All of these things would need to be addressed to create a natural result with a straight bridge on profile. Computer imaging is useful to give you an idea what the nose might look like after surgery. We do this in our office. Good luck!
ehmann143,Although your photos are not ideal it appears that you have an excess of supratip septum that is overwhelming your tip. Well rotated tip so make sure that you don't get anymore rotation. You are asymmetric as are most patients; see your lips are slightly cantered etc. looks like the left side of your face is larger than the R, not uncommon at all. See 2-3 rhinoplasty specialists and look at as many photos as possible pre op. Make sure you like their photos. See my web site as a good example. Good luck!!!!!