Rhinoplasty: Q&A

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Reduction Rhinoplasty

I want rhinoplasty surgery to make my nose a lot smaller, but my surgeon tells me I can't get have a size reduction as dramatic as I want. I am frustrated and don't understand why I can't have the little nose I want.

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21 Doctor Answers | Asked by anon

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There are anatomical structures of the nose which limit...

There are anatomical structures of the nose which limit the extent of modification; nasal bones, upper lateral cartilage and lower lateral cartilage. The nose must balance between these three structures. Thus, an extremely large nose cannot be made to be a short little flat nose. To achieve a well balanced and natural looking nose, all three structures must come together in a three-dimensional fashion to look great. Sometimes the amount of reduction permitted to establish this balance is... more

We always appreciate patients who present to us having...

We always appreciate patients who present to us having done some homework on their own because it lets us know that they are really preparing for their surgery and, more importantly, because it allows us to spend more time in really discussing the available surgical options. We find a lot of our patients, men and women, present with exactly this question and the answer largely depends on each particular patient’s anatomy. Sometimes, patients present with a large hump, which makes their... more

Size Limitations in Rhinoplasty

There are three considerations: Aesthetic: what may look right on your face. Too much reduction may be disproportionate, leaving a surgical or unsatisfactory appearance. Functional: over-reducing the nose can result in airway problems, including an inability to breath. Structural: There are limits that are inherent in the quality of your tissues, particularly the thickness of your skin. Thicker skin is limited in how much it can "shrink" to reduce the size... more

Making rhinoplasty too small

This is actually a very complicated question - 1. Considerations of aesthetics - finding a balance of your nasal shape and profile for your facial width and length and balancing it with things like the projection of your chin. It sounds like from this standpoint your idea of a beautiful nose is on the smaller side. 2. Considerations of your health - Reducing a nose too much can have an impact on your ability to breathe through your nose. In addition signifcant nasal reductions can weaken... more

Nasal surgery Rhinoplasty and Reduction in prominent nasal hump

Rhinoplasty techniques are used to acheive two basic goals: Achievement of nasal harmony Maintenance of a patent and healthy nasal airway The nose is composed of an underlying structural support that provides an open airway to facilitate breathing. As the structure of the nose is made smaller, the passageway to the nasal cavity is compromised and may cause breathing difficulties. An experienced plastic surgeon performing nasal surgery will take these two factors into account in order to... more

Rhinoplasty and limitations

The results of rhinoplasty are always limited by the underlying patient anatomy. It can not be made as "small as one always wants."

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Why a nose cannot be made very small

Reducing the nose too small can result in functional problems such as sinusitis or compromise of the nasal airway with obstruction see video

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Reduction Rhinoplasty: Creating the Tiny Nose

Anatomic limits determine how much a nose can be reduced. These limits affect the aesthetic, structural, and functional aspects of the nose. A nose that is excessively reduced may be disproportionately small when juxtaposed with the other features of the face. One that undergoes removal of a significant dorsal hump and narrowing of the nasal bones by osteotomies (to prevent an "open sky" deformity) can adversely affect the airway by narrowing the internal... more

There are limits to how small a nose can be made by a rhinoplasty.

There are anatomic limits to rhinoplasty. Primarily, as volume of cartilage and bone is reduced, the skin has to go somewhere. A well shaped nose needs structural support and if this is removed for the purpose of making the nose smaller, the result will be bad.

Limits to a Rhinoplasty

I understand your frustration, but like anything else there are limits to what can be done. The limitations of how small you can make a nose include, the skin envelope, the cartilage and the function of your nose. If you take out too much cartilage your nose will collapse and you will look terrible as well as not breathe well. The good news is that your doctor is being honest with you and is giving you realistic expectations. The problem I often see is that the surgeon... more

Making the nose very small

There is a limit to the amount of reduction of a nose that can be achieved because the principle is that cartilage and bone are removed and the skin must shrink to conform to what has been taken out. There ability of the skin to shrink, while quite satisfactory, is not unlimited.

Need for skin redraping limits nose size reduction

It sounds like your skin thickness is limiting how dramatic of nasal reduction your surgeon can perform. Surgeons must balance the ideal down-sizing of a nose with the anticipated ability for the skin to take on this new volume. When the nasal framework is made smaller you still have the same amount of skin that has to redrape over it (no skin is removed during the surgery). Luckily, thanks to scar contracture, the skin will "shrink wrap" to some extent around this new... more

Limits of how small I can make a nose

Every nose has limits of how big or small it can be made. The limit is based on the soft tissue envelope of the nose (the skin). Imagine the skin of the nose being like a dress, and the underlying nasal structure like a person's body. If you placed too small of a body on a thick, large dress, you would have excess material. Likewise, in a rhinoplasty making the nose too small can lead to a pollybeak deformity where excess bulk is seen in the tip. A... more

The smaller is not always better in rhinoplasty

Most patients come into the office requesting a smaller nose. In reality what they desire is a more balanced appearance to the nose. This may be done by a variety of techniques. After surgery they may say "my nose is much smaller now" in reality the nose may be only slightly "smaller" or even the same size.

Robert Mounsey, MD

5 reviews

Toronto Facial Plastic Surgeon

revesse.ca

Reduction Rhinoplasty: Making the Nose Smaller

It is possible for correction of a large nose to appear natural as long as the nose is proportional and in balance with the other facial features. But, there are some limits to how small a nose can be made. Skin thickness is the major determinant. The nasal framework can be made as small as possible, but the skin must be able to redrape around and conform to that framework in order to look attractive. One way to gain a better understanding of how rhinoplasty would change your... more

Making the nose smaller

There are limits to changing the nose based on where you start with your anatomy and ethnicity. Trying to create a really small nose will likely result in an unnatural, collapsed look which will appear deformed and fake. Trust the consult of a qualified surgeon and appreciate the limitations. Wishing you the best, Tal Raine MD

Talmage J. Raine, MD

5 reviews

Chicago Plastic Surgeon

How small can a nose be made?

There are technical limits to the reduction possible with Rhinoplasty. The overlying skin is often the limiting factor. Your skin can only shrink so much. If this limit is breached, the skin cannot redrape over the underlying nasal structures. This can cause a poor looking result. Another issue is the underlying cartilage and bone. If these are removed excessively, the function of your nose can be compromised. Its the skill and experience of your surgeon who can tell how much is safe and to... more

Making the nose smaller

Rhinoplasty is one of the more difficult procedures for a surgeon to master. In most cases a significant aesthetic change can be achieved. There might be a number of reasons why your surgeon can not deliver to you the result you desire. Most likely it has to do with your specific nasal structures. The goals of nasal surgery is to create a beautiful nose with nice proportions, not necessarily make nose as small as possible In my practice we offer... more

Limitations in Size of Nose With Rhinoplasty Surgery

Assuming the nose you are envisioning for your face is proportional and balanced, one major reason limiting how small you can go is skin thickness. If you happen to have thick skin and you reduce the skeletal structure of the nose significantly, there is a risk your skin will not shrink down to the new, smaller size. If this occurs, the definition and contour you desire will not be seen. Thicker skin does not shrink wrap down as easily as thinner skin. This is commonly the rate limiting step... more

Limitations of rhinoplasty

Rhinoplasty is a popular and effective surgery to recontour the shape of your nose. You and your surgeon are limited by what the tissues of your nose will allow them to do. In our practice, we find the use of digital photography and digital morphing software to be essential. We morph the photograph of every patient as this is an excellent education and communication tool that allows us to fully understand what the goals of the patient are and to show them what is realistically possible.... more

Any nasal reduction surgery has certain limitations. The...

Any nasal reduction surgery has certain limitations. The goal of surgery should be to create an aesthetically pleasing nose which still has good function (i.e. you can breathe out of it). To do this, a certain size of the nose must be maintained. In addition, the basic structure of the nose must be maintained. It is impossible to completely reduce the size of bone and other supporting structures of the nose and still maintain nasal shape and function.