Dr. Fleming is amazing at what he does! He is a big perfectionist, he will always listen and make sure you are 100% satisfied with the results. I truly had the best experience, I highly recommend him!
I wanted a rhinoplasty for years and when I was ready to do it I wanted a MD who specializes in noses. I could not find anyone in my area who specializes in noses or seemed to have a lot of experience. I read some of Dr. Fleming answers in the Q & A section and scheduled an appointment. I was very comfortable with him and with the years of experience that he has- so even though he is not in my area - it was over 2 hours one way to drive to my appointments - I felt it was worth the drive. Yes it did suck to spend over 4 hours in the car for a quick follow up appointment but well worth it. A rhinoplasty is a big deal and I don't think that it is something that you should skimp on in any way - ex. price, travel. Also we where able to do some follow up on Skype which helped. There was one feature of my nose that I hated but really did not know where to go from there. Dr. Fleming made suggestions, I felt confident that he knew what he was talking about and so went with what he suggested. I am so glad that I did. Before the surgery I read other reviews that said that he is good at knowing what changes will look good for your face and I completely agree. I was embarrassed to even talk about my nose but I was very comfortable talking with him. Also Maryann his assistant was SO helpful - really went above and beyond to help me get all of the pre-op stuff done. Maria his nurse is also amazing and made me feel very comfortable especially when I had questions or needed help with follow up. It has been almost one year since Dr. Fleming did my rhinoplasty and I love my nose. Just last week a friend said to me "I can't get over how amazing your nose looks" I can't say enough about Dr. Fleming and his staff.
Wow where do I even begin..... so I have always disliked my nose and knew I wanted a rhinoplasty since I was 12 yrs old, and honestly my nose needed a lot of work done. I had a long thin bridge but a wide, bulbous, and droopy tip. I also had a deviated septum and a hump in my nose. I also did not like my nostrils either. I was referred to the Beverly Hills institute by a coworker who had a rhinoplasty done over 10 years ago, and after checking out other real self reviews decided to go through with a consultation with Dr.Fleming. I had consulted with 3 other surgeons before deciding on Dr. fleming. I flew into Beverly Hills all the way from the East coast just for a consultation, and immediately knew in my heart that I would not be more comfortable or confident with any other surgeon then Dr. fleming and his staff. The day of my consultation a woman was scheduled before me for her rhinoplasty post-op appointment and when she came into the waiting room she looked so gorgeous and natural, so I was able to see his work not just online but in person as well and immediately felt comfortable. Next, the staff was so personable! Maryanna was such a sweetheart, and I really enjoyed conversations with her. They truly treat you like a friend/family member there, and not just as a patient. Next, I was incredibly impressed by Dr. Fleming, he did not rush me at all and allowed me to take my time voicing my concerns over my nose. He told me he could fix everything that concerned me and he even pointed out flaws within my nose that I haden’t even noticed before, so I knew right away he had the eye for detail that I was looking for. Not only that, he sat down and got to know me on a personal level and asked me about school and my major, etc. It felt like he truly cared about me as a patient and wasn’t after my money. That day I put down my deposit for surgery and it was truly the best decision I had ever made. Flash forward to the surgery.... it wasn’t nearly as painful as I thought it would be, I only needed painkillers the first 2 days. My bruising and swelling was perfectly normal but it really freaked me out and I had severe anxiety my first week of recovery, and even called the office freaking out due to my anxiety taking over. Dr. Fleming kindly called me multiple times over the weekend to help ease my nerves and even had me come into the office days before my cast removal just to talk with me. Dr. Fleming and his nurse Maria were so sweet and patient with me and really helped me cope with my anxiety, and with my permission Dr. Fleming even called my father to talk with him. It has now been 2 months since my rhinoplasty surgery and I am BEYOND thankful to Dr. Fleming and his staff. I knew my results were going to be good, but I didn’t expect them to be this good. This surgery has truly changed my life for the better, and although I don’t place my self-esteem based on outside appearances, the surgery has boosted my confidence in ways I never could have imagined. I am so in love with my new nose, it truly is perfect and I now for the first time in my life receive compliments on it by strangers on “how perfect my nose is”. I honestly think my nose is now my favorite physical feature. My new nose is gorgeous, but best of all it looks natural and I still look like myself but a better version. My breathing has also drastically improved. At the time of writing this review I am only 2 months post-op, and I still have a little bit of swelling and am already in love with my results. Getting a rhinoplasty done with Dr. Fleming was truly the best decision I’ve ever made so far!
Overall an amazing experience from start to finish. I could not be happier. Dr. Fleming and his staff are wonderful. Dr. Fleming took his time explaining everything, he addressed all of my concerns and answered all my questions. I highly recommend Dr. Fleming for anyone seeking revision rhinoplasty. He is a true master.
As a long-time patient of Dr. Richard Fleming of The Beverly Hills Institute, I can attest that he is a true master at his craft. It is challenging to adequately convey my thoughts in writing about Dr. Fleming's artistry and professionalism. What sets him apart from other cosmetic surgeons, I have used or met is his stellar work ethic. He does not make false promises; he's a realist who takes a conservative approach. The moment you step foot into his office, you're greeted by his extraordinary team of professionals. Both the office staff and surgical team make you feel like family and if needed, hold your hand throughout the entire journey. About fifteen years ago, I began seeing Dr. Fleming for Botox injections. It's only in the last two years I have undergone two cosmetic procedures - a year apart. In 2017, Dr. Fleming performed a neck-lift with a chin implant and a rhinoplasty revision in 2018. I could not be happier! Both procedures were flawless; he perfected what was imperfect, leaving me feeling refreshed with natural-looking results. My decision to undergo these procedures was not a hasty one. Dr. Fleming spent quite a bit of time consulting me. He answered every neurotic question that came to mind and at no time did he show annoyance or dismiss my concerns. It was important to him that I was 100% confident with my decision. Post-op visits were no different, any concerns during the healing process were addressed immediately, either in person or over the phone. At no time did I feel my access to Dr. Fleming was limited. As with anything, I highly suggest you do your research and make the decision that works for you. You will not be disappointed with Dr. Fleming and his team, especially when those friends and family start complimenting you on how fabulous you look.
I had a brow lift, bone contouring, hairline lowering, rhinoplasty, cheek bone implants, buccal fat pad removal all at the same time. I thought that recovery would be long and painful and that I would be in lots of discomfort. I was wrong. Dr Fleming is truly an artist and his precise incisions made it so that after the 3 day I stopped taking my pain meds. I couldn’t be happier with the results. I still look like me but with like a filter. He listened to how I wanted to look natural and he superseded my expectations. Post op care has been top notch. He has seen me about for times and still wants to see me every month just to check on my progress. I have had other plastic surgeons (the best in the industry) and none of them have offered the level of care and dedication that I got from dr Fleming and his staff. He’s truly the gold standard in Beverly Hills plastic surgery and a perfectionist which is exactly what you want when it comes to your face. Absolutely and totally recommend him
Dr. Fleming was great. I had a bit of a complicated Rhinoplasty revision. I had broken my nose a couple times, and then had a rhinoplasty procedure done about 6 years ago that wasn't desireable. He was able to walk me through the consultation process with ease, while answering any and all questions I had. I felt like he had the experience and proven results to help me out and perform the revision. The surgery went really well, and I'm thrilled with the results. Additionally his staff, and front office are great. I consider them all friends at this point, and I look forward to our follow up appointments.
Dr. Fleming's office is the ONLY place to go if you are considering rhinoplasty (primary, revision, reconstruction). In my case, I was in dear need of a facial reconstructive surgeon who would be able to correct my nose problem. I had two rhinoplasty procedures in the past, my primary ended up not being what I expected. My first surgeon attempted to fix my dorsal hump, which was my primary concern, but I also had a bulbous tip which he did not even touch. Fast forward, a week later when the cast came off I noticed immediately that my nose was crooked, still swollen but very noticeable. I was hoping that with time it would sorta "fix itself", but it obviously it did not. A year later I decided to get a revision rhinoplasty to address my crooked nose and bulbous tip problem. This second time around was my worst nightmare. Soon after the cast came off everything looked good "from the outside", but never did I imagine that two weeks post-op my nose (the graft work) was going to collapse from one side (the left side). To make matters worse, I then began to notice scar tissue build up inside my nose that covered majority of the nostril on the right, I believe that scar tissue is also known as "adhesion and or synechiae". In other words, I was not able to breathe properly and having that deformity inside my nose caused me so much frustration for a full year. This problem definitely needed immediate fixing. Fast forward a few months later of me finding Dr. Fleming (seeking a third surgery) on realself, it was the best decision I ever made. As soon as I left his office after my consultation, I knew that he was going to be my surgeon. With so many years of experience, Dr. Fleming knew my problem right away after evaluating my nose. He quickly diagnosed my nose and instantly knew what to do in order to fix my problem. He suggested for me to wait the remainder of the year for my nose to heal completely in order to fix it, but also invited me to come in every 3 months up until my year was up (visited his office 3 times for photos) to take photos of my nose to learn its evolution of the changes, which was more than I would have expected, very professional. I then decided to book my surgery on October 10th 2018. The procedure was a success and Dr. Fleming's team could not have been more amazing. Thank you for everything you guys did to make me feel welcome, I knew I was in the best hands. From booking my consultation with Mary Anna and her graciousness with my first visit and for answering all my questions and concerns; to Maria being the most caring nurse who was by my side since day 1, thank you!!! My nose cast was removed a week later where I learned a lot of reconstruction took place (numerous grafting with meticulous work). The nose reveal was the most emotional part of this whole process, I couldn't believe how perfect my nose looked despite the swelling. As the months passed by, now almost 6 months post op my nose looks wonderful, I am so happy with the results even though I have a few more months to go to see the full results. Again thank you Dr. Fleming and his team for changing my life, fixing my breathing problem and restoring my self confidence.
I was born with a very high hairline. Over the years, I learned to style my hair down so it would hang over my forehead and most people would never look twice. But I was always unhappy when it was windy out, I went swimming, or my hair would get messed up. I always assumed it just "had to be that way" and never realized there was any good method for fixing it. In the past few years, now in my 30s, I decided to look into options. I found forehead reduction and I was enthralled. I met with another surgeon first but found his attitude somewhat poor. He also tried to convince me to just do a "single stage" procedure that would only yield at most 2.5 cm reduction, which was not going to be nearly enough. I next met with Dr. Fleming, and I was immediately happy with him. Dr. Fleming is an incredibly kind and caring man who is passionate about his work and making people happy. He was honest when discussing options and interested in my case. He answered all my questions and I never felt rushed. He treated me with respect. He has a good sense of humor and good personal nature. And above all else, he is probably the world's best and leading expert on forehead reduction surgeries. Dr. Fleming helped pioneer the Fleming-Mayer flap and has performed various types of forehead and scalp reductions for decades. I have researched this field extensively and there is likely no other surgeon with the same type of expertise and experience he has operating today. The value of this experience cannot be underestimated. Furthermore, he has assembled a fantastic team of support workers who are every bit as engaged in the process as he is. Sharon was wonderful in helping to co-ordinate my dates, payments, and keep in touch. Maria, his surgical assistant, was fantastic as well in talking me through the process and giving me guidance along the way. Because the whole team has so much experience with forehead reductions, they are all experts in the process. I decided with Dr. Fleming to go for a two stage forehead reduction. He suggested, as I had noted, that my scalp was quite tight, and given my large forehead, a single stage procedure would not likely give me the amount of reduction I wanted. By implanting an expander first behind my hairline, and expanding it over the span of a few months to stretch the hair-bearing scalp, he could give me all the reduction I wanted during a second stage procedure to follow. My first operation to implant the expander went quite smoothly. I was awake the whole time with just local numbing to my scalp. Dr. Fleming and Maria made sure I was comfortable the whole time. They even gave me extra blankets to keep me warm in the cold operating room. The pain after the expander was implanted was more than I expected, but not too bad really. The percocets worked fine and I was back to work in around a week. I had a 3" or so incision at my hairline, but since I wore my hair down anyway it was easily hidden. After that, the next phase was to begin expansion. During this period, I had my dad inject 20 mL of water into a "port" under the skin connected to the expander at the back of my head. We would do this twice a week or so. The goal was to get to around 400 mL. Each time we would inject, it would feel a little tight for a day or two then I would feel back to normal. I ended up getting nervous near the end that I would not have sufficient expansion, so I went up to around 500 mL total volume. There is generally no harm in overexpanding, but if you don't have enough expansion, the final reduction can be limited. The toughest part of the procedure was hiding the implant once it got past around 250 mL or so. I already have a big head, so it was tricky. Once I got to around that point, I began wearing hats to work. It was winter so I just started keeping my toque on. Or I wore a fedora. If people asked, I would either play it off, or be blunt and jokingly say, "I'm actually having some surgery to my scalp, so trust me - for now, it looks better this way." People are pretty polite nowadays and no one even asked me anything to follow up after that. But if they seemed concerned, I would say, "It's no big deal, I'm just having something removed, and then it will be fine. It's just not pretty right now, so I'd rather wear the hat." By the end, the fedora worked to conceal the expander the best, although it was even lifting off my head a bit because I inflated the balloon so much. It was a huge relief to be done and know that it was finally coming out! The final procedure went quite smoothly. I brought some Photoshops to my final pre-op, showing Dr. Fleming where I and my family thought the hairline might look best. He said he could make it happen and just suggested also some contouring to make it look more natural. This is one of the things I love about Dr. Fleming. He doesn't adamantly tell you what you should or shouldn't do. He tries to help you reach what you are hoping for yourself, and guides you to make good decisions in that regard. When I had my bandages removed a day or two after the surgery it was quite a shock. I almost passed out lol. This was partly because I had gotten so used to having the balloon in, it looked like half my head had disappeared. My head was also a bit swollen and the stitches of course weren't pretty. And I had never seen my hairline look like that before. It was all a bit overwhelming. Dr. Fleming and Maria reassured me that everything was normal and looked good. By a few days later once I could wash the hair out and really get a sense of it, I agreed wholeheartedly! It was fantastic. The transformation was truly amazing. It changed my entire face and proportions and brought my features into much better balance. The hairline and jawline set the frame for a person's face, and when one aspect of that is out of balance it can throw everything else off. All of a sudden, I looked good with my hair up, or back, or parted, or anything at all. Every hairstyle I tried looked good. I followed Dr. Fleming's advice to use Aquaphor on the incision while it was healing initially. Then I switched to silicone scar gel in the months that followed. For the first few weeks, I had to wash it very gently in a bath tub as the whole head was very sensitive and I didn't want to tear the skin at the incision. Over time, the sensitivity decreased though and normal sensation has slowly returned to my scalp. I'm now at around 10 months post op and I am extremely happy. I have a dense, thick, and strong hairline. My hair is now something that gives me pleasure every day instead of being an annoyance. I received more compliments on my hair in the first few months after the procedure than I have for any other physical attribute in total over my entire life. Some of the types of comments I received were typically: "Wow your hair looks really good like that!" "You look like a rockstar!" "I am so jealous of your hair!" "Wow sexy hair!" "You look like Antonio Banderas!" etc. (it went on and on) No one knew I had surgery except my family, since no one else ever saw my hairline before. It doesn't look like I "had surgery" either, because the hair all perfectly matches in density, color, wave, and style. This is the advantage of a forehead reduction vs. a transplant. A transplant will never be able to get more than 50% of the density that your natural hair has, and it will never match the texture and direction of your natural hair. A forehead reduction on the other hand will always keep everything matching perfectly. After all that surgery, Dr. Fleming did such a nice job that all I have left is a tiny scar along the frontal contour of my hairline that is hardly noticeable unless your face is pressed right up against it to pick it out. Overall, this surgery with Dr. Fleming was one of the best decisions I'd ever made in my life. I wish I had done it when I was younger. I think I would have had a lot of fun in my 20s doing all sorts of crazy hairstyles. But I guess now I just have to make up for lost time. :) I would strongly recommend a forehead reduction with Dr. Fleming if: - You want the best and most experienced surgeon for this procedure. - You want a surgeon who is caring, compassionate, and dedicated to giving you the result you will be happy with. - You are a man or woman born with a high hairline or big forehead. - You are not suffering from male pattern baldness, or if you are, you have it under adequate control with effective medications and it is not progressing (if you are balding and get this procedure, it will not stop the balding process so it is not a solution for that). I would absolutely give Dr. Fleming and his staff 5 stars for the experience (or as many stars as I am allowed). My experience has shown that plastic surgery, when done well for the right patient and right condition, can improve quality of life and make people happier. That's what Dr. Fleming has done for me. I am incredibly thankful for his work, and I will always be grateful.
Dr. Fleming. Where do I begin? After a whole year and more of researching (EVERY. SINGLE. DAY) I decides to go to him to fix my nose that was carelessly done by my previous surgeon. Consultation? Amazing. He was pretty late ( As he was finishing up a patient--more on that later) but he apologized after (very sincere). He is very detailed and spend so much time with me, explaining EVERYTHING I asked and needed. Like, EVERYTHING. And his assistant? Maryanna, such a sweetheart and so was his nurse Maria. All so very kind and sweet! They will keep in contact with you and answer any question you ask, sometimes on weekends as well when you're recovering! Best service I've ever recieved! Dr. Fleming will ALWAYS find his way to see you before and after surgery and will always be there to see you at every follow up! I cannot express how thankful I am for all of their kindness and hospitality! My nose? Its still swollen but I love it so mich sinxe the cast came off! Will do a further in depth review but he is so amazing. Please, if you're in between doctors, have consult with Dr. Fleming as well! Updated on 19 Dec 2018: So here's a big major difference with my experience with Dr. Fleming and my previous doctor (Dr. Lee). Dr Fleming: - Was never rushed during the consult. He was a tad late because he made sure his other patient ins surgery was well taken good care of. The same care he also passed on to me during my surgery with him. We decided to do diced cartilages from my ears, wrapped with fascia. - Maryanna, his assistant, has always emailed me/called me to remind me of things I am missing or to give me an update! She is simply THE best! Will always answer any questions you have! - Dr. Fleming spent about 10 - 15 min. with me, before surgery, to make sure what we were doing and explaining the process. He was there when I woke up to check how I was doing and gave me a few advice before I head off home. - Maria, his nurse, shares the same kindness and knowledge as Maryanna. She helped me with EVERYTHING I needed for before surgery and after. While I was in surgery, she explained/taught my husband instructions he can help me with while I was recovering! So sweet! She checks up on me as well and always encourage me to call when I have any questions! - I followed up with Dr. Fleming the day AFTER surgery because he wanted to make sure I was ok and if things are going well. He took out the cotton in my nose and Nurse Maria cleaned me up and replaced bandages from yesterdays surgery! - Bandages and stitches were taken off yesterday by Nurse Maria and Dr. Fleming! I love how it looks! But he had to tape it down to control swelling! So I have the tape on for a few more days. It looked SOOO much better!!! They gave me a few more instructions and scheduled another appointment with me on 12/26. Conclusion: Dr. Fleming is very kind and VERY knowledgable. Showed me and my husband about what's he's going to do and whats going in my nose. He even encouraged us to do research as well! The staff are wonderful and will keep up every appointment! Also, don't be discourage or feel like he will not give you the time of day if hes a little tardy. He spends a lot of time and care with his patients and will pass that same gratitide towards you! Please address all your questions with him. He will definately answer! He was always there to for me during my visits! My nose is still healing and I am sooo happy on how it looks! I know swelling will probably change it a bit but honestly looks better than my nose with Dr. Lee. Dr. Lee: - Consultation was vague. Didn't explain much really. Did a silicone implant and cartilage from behind my ear for the tip. - Velma, his assistant is very nice and sweet! BUT! Never really called me back or updated me about schedule change till the very last minute. There was no email exchange. They were either short or none return. - During Surgeries (4 of them), I never saw Dr. Lee beforehand. Only for a few seconds and that was it. NEVER was around when I woke up. ALL surgeries took 1-2 hours. Instruction papers were just given to my husband and explained only little. - Follow ups were hard with him. He would reschedule the night before or hes nowhere in the office. After the cast were to be taken off, he looks at it and would say "Oh yeah, need a revision". - Staff never really calls back. They don't keep up with appointments and Dr. Lee is nowhere to be found! Calls always go to voicemail. Conclusion: Dr. Lee did not seem to care for me after messing up a few times. I was treated very poorly and questions were left unanswered. I wish they could refund my money but sadly, that will never happened. All in all, Dr. Fleming really made me feel like family or a close friend. He treated me the way he would want to be treated. I want to also note that I did saw 4 other doctors (Dr. Yoo as well) before deciding for Dr. Fleming. They were either too hesitent to work on me or their results weren't what I wanted. Either way, I am so very happy to have chosen Dr. Fleming! Pics are coming soon! Updated on 20 Dec 2018: Still have the tape on my nose. I understand that once the tape comes off. The swelling comes! But I am so happy with the result! Did not see any crookedness when I look up and looks really straight! Ears are still very sensitive :/ but it looks like its going back to normal! Heres a few tip I learned along the way to help me recover! - Do not wear any sunglasses/glasses. They leave a dent on your nose and puts pressure on it! Wait until your doctor gives you the ok! - Try to avoid the sun or any heat in general because it can make your face swell up. - I avoided salt completely! It helps the swelling! - I drink a lot of (cold) matcha green tea in general. They help with swelling as well. Oh and lots of water! - I slept on my back a lot. It helps make the nose not lean to one side. (Didn't have a choice on this surgery since both my ears still kinda hurts lol) Again, get the ok from your doctor! - Sneeze through your mouth. Do not blow it out. If it gets annoying. Sometimes I just let it drip out and then wipe it. I know. Gross. - Avoid looking down a lot too. Dont want your lovely new nose to hang. - For all you party animals, avoid alcohol and smoking. I know! But do it for your nose! That nose cost more than that bottle! They will always be there, but your nose will not! Above all else. Contact your surgeon! If he's avoiding you or being unreasonable, please contact another one. It's better than not knowing and stressing your skin out. PS trying to upload photos but it wont let me. I'll try again tomorrow. Updated on 24 Dec 2018: So, after the cast removal last week. Dr. Fleming taped my nose. It was supposed to be removed on the 26th BUT, I had to go to work on Sunday. He said I could take it off then. But luck on my side, someone grabbed my shift. So Monday, today, I HAVE to work. (I know, christmas eve but I'm needed) I took my cast off today and omfg!!! Its PERFECT!!!!! Its swollen but so far, no bumps yet!!! (Fingers crossed) Still haven't figured why my photos would upload???? Going to try again after work! Updated on 30 Dec 2018: I hope this uploads!! I am STILL a bit swollen and will be for the months ahead so I do have a bit of make-up on! I was super busy with personal life that I totally forgot all about updating this! I saw Dr. Fleming on the 26th and prescribed me more antibiotics just incase. And answered more questions for me. I am also going to see him again and a few more weeks! What I really appreciate about him is the fact that he came on his OFF DAY just to see his patients! After christmas?! Wow! Swelling is going down slowly. As expected. This is my 5TH revision. But its healing down nicely! Keeping my fingers crossed that it will stay that way!!! Updated on 15 Jan 2019: Ugh. I hate hate hate my nose before. You can tell its crooked. Everytime I scroll through my old pics, it makes me so upset with my previous surgeon and sooo thankful for Dr. Fleming. I havent been checking on this for a while. I am really busy with life. I did a follow up with Dr. Fleming a week ago and he said everything is as it should be. I am still really swollen. But like I stated, its to be expected. All in all, it looks good! I cant lie and said everything was perfect. There was a bump on the right side of my nose BUT, it is going down! It looks way better than what I had before. I am really so happy! Also, I am sooo happy he straightened and got rid of my polybeak! Ill post more pictures soon!! Updated on 22 Mar 2019: Hey guys! Just a little update! I have been quite busy! Everything is going swell! Lots of the swelling went down and I'm so in love with the tip of my nose! I met up with Dr. Fleming a few weeks back just to see how everything is going. I did address the bump on the side of my nose as I stated in a previous post and its actually getting smaller! I hope it disappears before a photoshoot Im doing in the next few months! But I understand that swelling takes time, expecially after multiple revisions. Yikes. Will do another update after my next appt. in April to see if anything progressed! So far, so good! I'm happy with the results! Updated on 13 Nov 2019: Hello guys! Omg it's been quite awhile! Life has been very busy. I have big (great) changes in my life that I completely forgot to keep you guys updated. I just had my follow up with the Doctor yesterday and things are going swell. I'm still healing because of course, multiple surgeries were done before. Again, I am still so happy with the care they have given me. They are sooo sooo kind. They always answered any questions I have and even educated me on a thing or 2. It's never hard to schedule appointments. I really enjoyed every single visits I have with them! Next month will be my year mark and I will post pictures to update along with the months that to led to my final results!
Forehead reduction, hairline lowering, and orbital bony contouring can all be accomplished using the Irregular Trichophytic Hairline Incision technique that I described many years ago. Bone contouring is achieved by shaving the excess bone.
An osteotomy can narrow the bridge but not add height or increase nasal projection. Fillers or grafts are necessary to achieve that temporarily or permanently.
A bifid tip is a common problem successfully corrected by experienced rhinoplasty surgeons with minimal risk. A noticeable improvement can be achieved and is usually eliminated.
Your tip can be refined but the skin thickness, which can be difficult to evaluate in pictures like these, will limit what can be achieved I encourage you to see an experienced rhinoplasty specialist. Ask to see results in noses similar to yours.
Lifting your hanging columella can be done with a straight forward procedure under local anesthesia if you prefer. However I encourage you to consider narrowing and refining your wide tip cartilages at the same time for a complete result.
