Full rhinoplasty or tip plasty to fix my front view? (Photo)

Question

I am interested in getting a rhinoplasty but I am not entirely sure what makes the most sense. I don't mind my nose from my side profile but I can't stand my front view. I also don't like the way it spreads when I smile. I'm not sure if I could just have a tip plasty to fix this or if a tip plasty would just call for me needing a full rhinoplasty to make everything proportionate. There is also the fear of keloids and scarring that could possibly heal improperly.

Nima Shemirani, MD · Answer

Hi @msefin05. Based on your photos, you have thick nasal skin, a broad tip, a low bridge, and wide and large nostrils. I recommend seeing an expert rhinoplasty specialist for in person examination. There are several options for you that can be determined after examination. A rhinoplasty in my opinion is one of the most difficult procedures to perform. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. Best of Luck, Dr. Nima!

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have thick nasal skin and a broad flat nasal appearance. In order to achieve maximal narrowing, osteotomies would likely be necessary. Hope this helps! Dr Joseph

Oakley Smith, MD, FRCSC · Answer

Hello,
A surgical rhinoplasty to address the tip by refining it and rotating it slightly in addition to alar base reduction to narrow the base of your nose would be the better choice to improve the look of your nose. It is better to consult with a facial plastic surgeon who can examine you and discuss the expected result of the surgery with you.

Ronald Schuster, MD · Answer

I suspect that you will need a full rhinoplasty. What needs to be done really depends on the final result you are looking for. Your dorsum is low but it doesn't have to be changed if you like it. Even if you like the height I think you will need to have it narrowed because you want the tip more narrow and it will create a much better balance. It is important to communicate your goals during your consultation. Take photos of celebrities/models etc. to show what you are looking for. A good rhinoplasty surgeon will be able to let you know if it is possible and what would be needed to get you there. Good luck.

Andrew Miller, MD · Answer

Based on your photos, you are a good candidate for rhinoplasty. Yes, the nasal skin is thick and will limit how thin the nose can get. But the cartilage can be strengthened and skin thinned from the inside, which will make an improvement. You just have to have realistic expectations. The nasal bones can also be narrowed as well. Be sure to see a rhinoplasty specialist for consultation.

George Bitar, MD · Answer

Based on your photographs, you have nasal features characteristic of an ethnic nose with a thick skin, broad tip, low bridge of the nose, and wide and large nostrils.  It would depend on what really bothers you about your nose.  Based on your description, if it is only the spreading of the nostrils, that can be improved by removing a portion of the nostril, which is called alarplasty.  However, for a better proportioned nose, you may consider augmenting the bridge of the nose, making the tip more refined, and narrowing of the nostrils.  That would be better obtained with a full rhinoplasty.  I would recommend consultation with a board-certified plastic surgeon with experience in ethnic rhinoplasty to discuss your specific concerns and come up with a plan.

Ronald J. Edelson, MD · Answer

Just the tip is not enough. You need your bones and just rips made narrower. I see you live in anchorage Alaska. Not sure if there is the expertise available to you. You may need to travel

Zoran Potparic, MD · Answer

You have a typical presentation of an ethnic nose, with thick skin, broad tip and nasal base, broad nose bones and low dorsum. Nose like this should be corrected at multiple points starting with narrowing the nose, augmentation of the dorsum, refinement of the tip and adjusement of broad nose base and nostrils. In person consultation with a board certified plastic surgeon, expeert in rhinoplasty and ethnic rhinoplasty, is recommended. Good luck.

Philip S. Schoenfeld, MD, FACS · Answer

You are an excellent candidate for rhinoplasty if that is what you desire.  A rhinoplasty will help balance all parts of your nose.  Create more of a defined tip, narrow the dorsum, and slightly raise the dorsal height.  Alar width can also be addressed.  Keloids, though a reality, are fortunately uncommon in rhinoplasty and I perform a great deal of ethnic rhinoplasty.

Leo McCafferty, MD · Answer

Thank you for your question.  I believe the issues with your nose could be addressed with a tip rhinoplasty along with reducing the alar flare.  Your concern regarding keloids is a valid one but keloids are rare in this location.  I would suggest you see a board certified plastic surgeon experienced in rhinoplasty and discuss your personal history of scarring as well as family history of scarring during that consult.  Good luck!