Improving nose without full rhinoplasty?

Question

I am interested in making changes to my nose. For reference, I have an aquiline nose (medium dorsal hump and droopy tip). Due to my occupation, I’m concerned about the recovery time after rhinoplasty where the nose can’t be bumped. Is there anything that can be done to improve my nose, even a little, that would not require caution for it to not be bumped afterward. I’m wondering about rasping some of the dorsal hump, or something with the tip. I’m not interested in nonsurgical rhinoplasty.

Eric M. Joseph, MD · Answer

Normal social activity is resume seven days after rhinoplasty surgery, and the structure of the nose is fairly stable 2 to 3 weeks after rhinoplasty surgery. If you wish to have your nasal tip elevated and your nasal bump removed, rhinoplasty is the only feasible option. Thank you so much for your question. Sincerely, Dr. Joseph

Lexie Wang, MD · Answer

Tip- you'd still have to be cautious about not having any trauma to the nose. Rasping of the hump- you could maybe get away with doing this with minimal downtime, but you have to be cautious because (1) most dorsal humps to be treated all the way will require some form of osteotomies/breaking of bones, which means that you have to again be cautious of postop trauma, and (2) rhinos are really not something you should "half do". You should get everything done or nothing. Don't leave room for regret / possibly coming back and doing more in the future.

Steven M. Denenberg, MD · Answer

First of all, you can get into trouble if you only correct a subset of what bothers you about your nose. For example, if you just have the bump lowered, it can make the nose *look* longer, as if the tip had drooped more. You'd like your nose less than you do now. Also, lowering the bump could cause a flat spot where it was taken off, unless the nose is narrowed at the same time.

Then, you've only done a little bit, but it's a real rhinoplasty nevertheless, so if you decide later that you want/need the other areas of your concern to be addressed, that's a revision operation, much more difficult than a first-time operation, and probably you wouldn't be able to get as close to your original goals.

And finally, I don't think the nose is fragile after the splint comes off. I've never had a patient who's done damage to her nose after the first week, and lots of people bump the nose. Hard. The cartilages aren't going to displace, and the bones aren't going to break. If someone hits you with a sledge hammer, sure, but any nasal bumps that you currently tolerate almost certainly wouldn't be an issue.

You mentioned that the bump and tip elevation are two of your issues. How *much* to elevate the tip, or lower the bump, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs -- particularly the elevation -- require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

E&amp;G Aesthetic Institute - Med Spa, Newport Beach · Answer

It is hard to tell for sure without an examination and photos, but based on your description you may be a good candidate for a non-surgical rhinoplasty. Non-surgical rhinoplasties are a great option for those who want limited down-time as the results are generally visible within 2 weeks and depending on the type of product used - results may last up to 1.5-2 years. When considering a non-surgical rhinoplasty, I would suggest that you evaluate different factors such as recovery time, percentage of improvement, and what your specific aesthetic goals are. A Skype or FaceTime consultation with a non-surgical rhinoplasty specialist will help you get an accurate recommendation and pricing. Respectfully, Elena Gavilanes, Plastic Surgery PA-C

William Portuese, MD · Answer

It's important to post a full set of facial photographs from all angles to make a determination about how best to proceed. When performing a rhinoplasty, there are a sequence of steps that occur to ensure that the noses looks good in a three-dimensional fashion. Only performing a partial rhinoplasty will probably make your nose look half-baked

Improving nose without full rhinoplasty?

Answers (5)