Walter Joseph, MD

Hi alcg2017! Dr. Walter Joseph here from Beverly Hills, CA! Based on your photos, I think your goals are certainly realistic! A dorsal reduction can be performed (i.e. removing the "bump"), while still maintaining a straight bridge WITHOUT a ski sloped or scooped appearance. As for your tip, it would totally be up to you as to if you want any tip work done whatsoever. Some patients choose to preserve their tip while only addressing the dorsal hump, which is both reasonable and achievable! I will say however, that with a significant hump reduction, it is often necessary to bring in the nasal bones via nasal osteotomies, which would result in a likely narrower appearance of the bridge of the nose on the frontal view. A thorough in-person physical exam would be needed to determine if this would be necessary. I hope this helps!

Hi Chlo98! Thanks for your question. At least from your photos, you are certainly a candidate for rhinoplasty. A surgical rhinoplasty would be able to lower your dorsum (remove the bump) and also de-rotate and de-project the tip of the nose so that your nostrils show less on both the front and side views. Also, with cartilage grafting and special maneuvers like an alar base excision (Weir excision), the nostril size can be decreased further and the ala can be better supported.

Bruising after a rhinoplasty is nearly resolved at 1 week and almost always fully resolved at 2 weeks. Swelling can last anywhere from 2 weeks to 6 weeks or longer depending on your anatomy and the extent of the surgery. I always counsel my patients that in some cases for primary rhinoplasty, the final "product" is really not visible until 1 year.

Hi SpiceMix! Thanks for your question. Dr. Walter Joseph here from sunny Beverly Hills, CA! As we age, we lose bone density and develop some soft tissue atrophy in what's called the "pyriform" area of the nose, which is the structure deep to the alar crease that you're describing. Also, some people (regardless of age!) have a genetically deeper set pyriform than others, which can also make the alar crease more pronounced. A nice treatment for this is to inject a thicker hyaluronic acid filler deep onto the bone of the pyriform in the crevasse just beside the ala. This helps build up this area and lessen the depth and the shadowing caused by the depth in this area. I hope this helps!

Hello Cute7275! Dr. Walter Joseph here from Beverly Hills, CA. I hope you're well. It appears that you likely had an open rhinoplasty, where an incision was made across the columella at the base of your nose. If there is any sort of step-off at the closure between the skin edges, a "notch" or "dent" can occur. Sometimes, these scars can remodel and any irregularities can improve/resolve over the course of 1 year, however, if there is still an indentation at the 12 month point, I would recommend that you return to your surgeon for a small revision under local anesthesia. Happy to comment or help further if needed!

Hi Malo10! Dr. Walter Joseph here from Beverly Hills, CA. I hope you're well! For my patients, I typically recommend starting both Arnica and Bromelain 1 week prior to surgery. I then recommend that they continue the combination for at least 2 weeks post-op (a total of 3 weeks). As for red light therapy, you can actually begin red light therapy a day or 2 before your surgery, and then continue daily for as long as convenient. There is good data that red light therapy can decrease pain, swelling, and overall inflammation and also speed up healing/recovery.