What features of a nose can be changed and what features cannot be changed with a Rhinoplasty‘?A Rhinoplasty can change, at least to some extent, virtually every feature of the nose including its length, projection, width, tip/lip angle, etc. there are some things that can be changed virtually without limit these would include the Length and projection. The width of the tip can be reduced in bulbous tips, but in people with thick skin the amount to which it can be reduced is limited. Although in such cases with thick skin tips Cortizone shots during the healing phase and after can further reduce the thickness of the tip. Noses which are extremely crooked cannot always be made perfectly straight but can usually be made straight enough that the residual crookedness is 80 or 90% better than it was and can be finished off with a minor secondary procedure. Somethings can be changed but the procedure to change them is not very reliable and may cause asymmetries. An example would be procedures to change the arch of the nostril for people with very high arching nostrils. So in general there are very few noses that cannot be significantly improved with rhinoplasty, but there are some noses for whom the improvement will be less than for others. I have found that the most dramatic “home run“ cases are people with long noses possibly also with a dorsal hump who’s tips droop but who’s skin is medium and not excessively thick and who have adequate projection of the tip and columella. People who fit these characteristics I feel will usually get the best and most dramatic results. The least benefit ,at least from standard rhinoplasty, would be someone with very short noses flat noses which lack projection . flat tips with short columella‘s and extremely wide tips and thick skin . Such a Patient should be told quite frankly of the limitations of traditional rhinoplasty in that setting. For noses such as that, grafts can be used to build up the dorsum but these introduce a whole new set of risks and potential failures.
