I have a dorsal hump that I want removed and would also like a bit of tip work done since I know removing just the hump will make my nose appear even longer. I don't live in a big city and we only have 2 plastic surgeons in my town that both have good reputations. However they both seem to specialize in things like breast implants, liposuction, facelifts ect. Not a ton of rhinos. They both said they probably average about 12 to 50 a year. They both have been doing this fo over 20 years and both seemed comfortable doing the procedure. However I keep hearing from doctors on this website that you need someone who does at least a hundred or so a year, so that makes me a little nervous. The first doc I saw looked and me and basically just said you I can do that. Didn't give me a ton of details but seemed to think it would be easy and that rhinoplasty is his favorite procedure to do. Just said he would get rid of the hump, break my nose, and do some tip work and that would be the end of it.
The second one however was way more detailed! He actually examined my nose thoroughly and told me first and foremost I already have a very thin nose and skin so shaving down the bump and then breaking it could give me to narrow of a nose. He was also concerned about my airway being affected. Something about a sunken v deformity could end up happening and affect my breathing. So he believes filing down the hump and using osteomosis along with spreader grafts is the best choice. Also he weigh some tip work. Also mentioned something about the bone coming from my nose towards my lip? Something about cutting that which would cause my upper lip to not be tensed? Which can apparently affect the distance between the nose and lip? I need to ask him about that again. I didn't fully get it. I didn't even realize my upper lip was tense. Also this doctor is a lot older. Probably early 70s but I'm not sure if that matters. Anyway, still deciding who to go with. I'm a little sad my choices are so limited because of where I live but I just can't afford the time and traveling costs that would go into going with an out of town surgeon, and the nearest big city we have is 5 hours away. I could be nervous for nothing and these guys could do a great job. I just don't know how many nose jobs it takes to make a surgeon great at it. From what I'm hearing these guys have done hundreds in their career but definitely not thousands. If you wanna see photos I have some posted on previous questions I've had for other doctors.