Recommendations for Rhinoplasty And/or Other Procedures? (photo)

Hi! I am wanting to get rhinoplasty. Both nostrils are assymetrical and the tip is wide. Would changing the shape of my nose decrease the nostril size? I also feel that the distance between my top lip and nose is too long. I have tried fillers in the past but the results tend to make it look more "duckish" than actually decreasing the distance. Also thoughts of chin implant, would that be needed? Can a patient fly if they are from out of town? Thank you for any advice!

Doctor Answers 9

Recommendations for Rhinoplasty And/or Other Procedures?

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Dear Designermomma,

Thank you for your question and photos.  On assessment of your face, You seem to have a 'C' type curvature of your nose.  There is also a convexity to the bridge (dorsum) of your nose.  The tip is wide and bulbous, and nostrils large.  The lip is slightly long and there is a moderate deficiency of the chin.  Most of these things are correctable.  The bridge of the nose can be sculpted, the curvature removed, the tip sculpted and narrowed.  These have a small effect on the size of the nostril, but a true nostril reduction involved excision of the alar bases, which I think leaves a noticable scar, and do not think is worth it.  Lip shortening procedures also are not worth it in my opinion, but a lip augmentation with a silicone implant can look very natural, and mask the longness of the lip.  The chin implant will also help giving you more balance.

Best Wishes,

Pablo PRichard, MD

Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Recommendations for Rhinoplasty And/or Other Procedures?

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       Reduction of the size of the tip and refinement of the nostrils can be accomplished with a closed rhinoplasty.  A chin implant will help balance facial proportions as well.   Patients fly in from different parts of the US and outside the US on a regular basis for these procedures.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and chin implants each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Surgery to correct tip and long upper lip

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Changing the shape of your nose can be done to make it look more refined. An alar base reduction can also be done to narrow the width of the tip. Asymmetric nostrils are often related to a deviated septum. An exam would be needed to determine the exact cause in your case.

A good way to shorten the length of your upper lip is by having an upper lip lift. You can read more about this procedure on my site.

It is quite common in my practice for patients to come into Seattle from out of town for surgery. You can find more information about traveling to Seattle for surgery on my website.

You can read more about wide tip repair at my web reference link below.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Reducing Nostril Size with Rhinoplasty Surgery

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Your tip can be refined and the width of the nostrils reduced and the asymmetry improved with rhinoplasty surgery. I would also improve the nostril retraction which is present. A chin implant would help balance the projection of the nose and chin. Every week I see patients who fly from other locations. This week I have operated on patients from Denmark, Chicago, and San Francisco.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty to decreased nostril size

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 A simple ala-plasty procedure is at all it is needed to decrease  the width of the nostrils. This involves an incision placed at the bottom of the nostrils along the alar sill to decrease the width of the nostril base. If the width of the nostril base is asymmetric than differential amounts of skin can be removed in an attempt to make the nostrils more symmetrical.  too narrow and refined tip of the nose sutures are placed in the  nasal tip cartilages along with conservative cartilage removal. Hump  removal and osteotomies were also performed at the same time when needed. Many of our patients fly in from out of town and out of state to have their rhinoplasty procedure performed in our outpatient surgical Center. Plan on spending at least a week in town prior to returning home.  Postoperative followup is also important as well the first few months after the surgery The link below has instructions for our out of town patients, virtual rhinoplasty, and  our photo gallery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Best Rhinoplasty and/or Other Procedures

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Hi Uneven,

Rhinoplasty would help you achieve your nasal aesthetic goals.  I do not believe that you need a chin implant.  You may fly after rhinoplasty approximately 5 to 7 days after your surgery.  Maxillary augmentation may help decrease the distance between your upper lip and nose.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Rhinoplasty and long upper lip

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Your posted photos show a long upper lip, a bit too much nostril show in the frontal photo, some outer nostril rim notching and a round tip. It is not clear that the nostril base is too wide. It just may appear that way because of the notching.

To reduce the notching you would need adjustment of the tip cartilage and possibly a composite graft inside the nose. I am not sure a chin implant is necessary.

The upper lip length is more difficult to treat than the nose. Incisions just under the nose look unsightly in my opinion especially in a case like yours where this area is so visible. Excision of skin just above the lipstick wearing area also can leave bad scars. I have had success with subperiosteal facelifts for this but it is not for everyone.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Recommendations for Rhinoplasty And/or Other Procedures?

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 From the photos provided, the nasal tip is a bit wide and could be refined with a Rhinoplsty.  The Lips are thin and could be augmented with Alloderm Lip Implants that are soft and supple.  The material lasts about 7 years and gives a soft, fuller look than any of the other lip Implants in my opinion.  The "duck" look, with lip augmentatioon arises when the MD doesn't understand the proper aesthetic proportion between the upper and lower lips.  When the upper is larger than the lower...the lips appear "ducky". 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Rhinoplasty and shortening the upper lip distance.

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Rhinoplasty and shortening the upper lip distance can be done. The upper lip lift is the only way to shorten this. The rhinoplasty can refine your tip and narrow your nostrils. You can fly 6 days later. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.