You have an important asymmetry and deviation in a few areas of the nose. To correct all this problems you will need a complete open structured rhinoplasty, with nasal bone fracture, hump trim as I dont really think there is an impoortant hump present only the broken bones, alar cartilage reposition to treat the tip, and a few grafts to restructure the nose. Find someone that performs open structured rhinoplasty, any other technique will not address all of the problems.
Best of luck,
Hump reduction, tip refinement but other procedures too...
In this case it seems so obvious to remove the hump and reshaping the tip but they are not sufficient to achieve an excellent result. In my opinion it needs cartilaginous grafts in order to reconstruct the framework of the nose and correct the outcomes of the previous traumas and if the septum is present, it is a very good source for the harvesting. So more than an aggressive lowering of the nasal dorsum it is important to fill the supra tip area and strength the caudal septum with grafts in order to have a perfect straight profile which must be in harmony with the male feature. Regarding the frontal view it is evident the presence of crooked nose and the indication of spreader graft or crossbar graft on the concave side and osteotomies too. Probably inside the nose there is a septal deviation with functional problems and in this case septoplasty should be carried out. Special sutures of the alar cartilages are able to correct the bifid and bulbous tip. At the end of the operation thin graft of crashed cartilage will be very useful as final touch up to correct irregularities and obtain an excellent result.
Do I need hump reduction and tip refinement?
one ever "needs" a rhinoplasty. It is an elective procedure and only
you can determine if your nasal features concern you enough to do something
about improving the cosmetic appearance of your nose and whether it would be
Following the advice from a surgeon on this or any other website who proposes
to tell you exactly what to do based on limited 2 dimensional photos without
examiningyou, physically feeling the
tissue, assessing your desired outcome, taking a full medical history, and
discussing the pros and cons of the operative procedure would not be in your
best interest. I would suggest you find a plastic surgeon with extensive nasal
surgery experience who is certified by the American Board of Plastic Surgery
and ideally a member of the American Society for Aesthetic Plastic Surgery
(ASAPS) that you trust and are comfortable
with. If you live outside of the United States, the surgeon should
ideally be a member of the International Society of Aesthetic Plastic Surgery
(ISAPS). You should discuss your concerns with that surgeon in person.
about the procedure will help you decide if it is a procedure that you want to
Robert Singer, MD FACS
La Jolla, California
I think the dorsal hump that you are seeing is an illusion because your middle third of the nose is depressed. Your nose is crooked and you would need the nasal bones straightened. You would require a cartilage graft for the middle third deficiency and the tip needs refining. Given the thins kin that you have a fascial graft taken from in the hairline of the temple is likely to be required.
Thank you for your question and photos. From your previous trauma, it appears that your nose has several irregularities. Working from the top down, the nasal bones are not straight. They are slightly too wide as well. You have a small bump that looks fine in my opinion and some people really like a very small bump on a male nose (this is a personal preference). More importantly, it is likley you have lost support to the midvault (area below the nasal bones, but above the tip) leading to a wide, flat midvault and supratip. Your tip cartilages are not optimally shaped. The irregularities of the tip are especially apparent because you have very thin nasal skin and thus it shows every small irregularity more. Each of these can be corrected by a rhinoplasty specialist. You will likely need fascia grafting to give the appearance of thicker nasal skin as part of the procedure. See a rhinoplasty specialist in your area who can guide you through the process. Al the best!
Closed rhinoplasty candidate, some advices:
Thank you very much for sharing your concerns with us.
The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.
In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.
Dr. Emmanuel Mallol Cotes.-