Rhinoplasty

Nonsurgical Nose Job

You are right rhinoplasties are a difficult operation and even in the best hands will still have about a 10% revision rate. So all aspects of the surgery need to be based on a thorough understanding of the aesthetics of&nbsp;nose, its anatomy&nbsp;and rhinoplasty techniques. That being said taking down a small bump is usually an easier endeavor in that there is 1-2 mm of leeway in how much can be removed. However,&nbsp;even this can be over or underdone and can leave an open bony roof or breathing problems if not done properly. Fixing a crooked nose can be a challenge especially if&nbsp;there is cartilaginous involvement as the cartilage has memory and this can rebend with time. Tip changes when they are small can be straightforward but again can cause major issues if overdone. Changing rotation, projection and length of the nose are all very technically demanding and are difficult to execute well. Best bet is to not ever assume a rhinoplasty will be easy and only go to a board certified facial plastic surgeon or plastic and reconstructive surgeon who does a lot of these operations.&nbsp;

They say rhinoplasty's are one of the most complex surgical procedures out there. Are there any aspects of a rhinoplasty that may be considered less harder than other parts of it? for example the shortening of the nose might be relatively easy to do compared to a straightening of the bridge etc. Where does each part of a rhinoplasty rank in terms of difficulty?

What parts of a rhinoplasty might be considered 'easier' or a lot less complex?

Without examining you and from a single picture I can only give you a relative assessment of your issues. Big also means different things to different people.&nbsp;Sometimes when patients come into my office and feel that their noses are too big, it is actually&nbsp;that their profile is out of balance. When we look at the size of the nose there are several factors, but a big one for patients is their projection or how far their nose extends away from their face. This can be determined by specific measurements but&nbsp;can be estimated by looking at the length of the lip with the length of the tip of the nose. Your measurements&nbsp;looks relatively the same, or&nbsp;perhaps the nose is&nbsp;slightly overprojected. Your profile also shows that your dorsum could be taken down a little bit as well to give your nose a more refined appearance. Your projection can be reduced while rotating up your nose a slight bit by some minor refinements in the tip during an open rhinoplasty. This would produce a subtle deprojection of the nose (or move the tip in a bit), a slight decrease in rotation (upturn it a bit) and some reduction the the dorsum (remove a tiny bump) giving it a more refined appearance. That being said,&nbsp;the thing that is most apparent is that you have a relatively small chin. When one looks at a woman's chin from her&nbsp;profile it should be just shy of the lower lip. Yours is a bit back from that point. There are a few reasons why this could be: you could have an overbite, you could have a normal bite&nbsp;with a small chin or a combination of both. Overbites usually are best fixed by an oral maxillofacial surgeon to advance the jaw. If you have a normal bite or are unwilling to have the advancement a&nbsp;small chin is helped dramatically by a chin implant. This strengthens your profile and helps your neckline as well. This procedure is very simple and can be done in the office in about an hour. If you did this you may find you don't want to do anything to your nose. I would recommend obviously seeing a local board certified&nbsp;facial plastic surgeon or plastic and reconstructive surgeon that do a large volume of these cases. Good luck!

If so how can I make it smaller? How can I make it closer to my face and curved up?

Is my nose too big for my face? (Photo)

The most common fillers for this purpose now are HA's such as Restylane or&nbsp;Juvederm. These products have slightly different properties but both work for this purpose. It is more important to choose a qualified injector than the particular HA&nbsp;in my opinion.&nbsp; &nbsp;&nbsp;The advantages of these fillers for liquid rhinoplasty&nbsp;are that they are relatively smooth, moldable, produce less inflammation than thicker products, and if necessary they are reversible. Because there is not much motion in the nose the product can last a year or in some circumstances longer. The most common indications would be to smooth out a bump, change the rotation or projection of the nose. Fillers can work as sort of a rent with an option to buy meaning if you like the way the nose looks you could consider a rhinoplasty for a more permanent correction.&nbsp;&nbsp; &nbsp;However, these must be used with caution. There is a potential to create inflammation and contour irregularities if not injected properly. Further there are reported cases of skin necrosis when using fillers in the nose.&nbsp;These complications&nbsp;would make corrective surgery more difficult.&nbsp;If you absolutely do not want surgery fillers can be done safely but make sure you go to an experienced injector with knowledge of the products and the anatomy of the nose to limit the chance of these potential pitfalls.

What is the best filler for nose imperfections?

Dermal Fillers

Matthew Wolpoe, MD

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Facial plastic surgeons have the training and certification to perform rhinoplasties, facelifts, chin and jaw surgeries, eyelid lifts, and other head and neck procedures.

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Trefor Nodwell, MD

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SkinMedica

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Jack Zoumaras, MBBS, FRACS (Plast)

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Dermabrasion

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Revision Rhinoplasty

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Marotta MedSpa

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PRP for Hair Loss

Renuvion

SculpSure

FamWellMD - Jacksonville

FamWellMD

Etre Cosmetic Dermatology &amp; Laser Center - New Orleans

Etre Cosmetic Dermatology & Laser Center

Clear + Brilliant Badge

Medical Rejuvenation Centre - Vancouver

Medical Rejuvenation Centre

Quintessa Aesthetic Center - Middleton

Quintessa Aesthetic Center

Halo Laser

Skin Boss Med Spa

Skin Boss

Aquagold

BroadBand Light (BBL)

Clear and Brilliant

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Dysport

NovaThreads

truFlex

truSculpt

I was nervous about going to visit a facial plastic surgeon, but Dr. Wolpoe made me feel incredibly comfortable. It felt like he really listened to my concerns and what I was looking for and took time to answer all of my questions. He and the staff were incredibly friendly. Hands down the best experience I've had at a doctors office. I'm excited to go back!

Hands down the best experience I've had at a doctors office

ame76

He takes his time with me each time I come in. He is professional and very knowledgeable.  I love my results. The ladies that work there are great as well. Friendly and got me signed up for rewards!!!

I highly recommend Dr. Wolpole

PrincessJes

4 Answers from Board Certified Facial Plastic Surgeon Matthew Wolpoe, MD See Education, Board Certification, and Treatments Offered.

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Johns Hopkins Hospital, Baltimore, Maryland

Johns Hopkins University School of Medicine, Baltimore

Franklin &amp; Marshall College

MD, Mount Sinai School of Medicine

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Montana

Billings

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