Rhinoplasty for Wide Nose, Bulbous and Overprojected Tip, Large Upturned Nostrils, Possible Septoplasty? Opinions Please? (photo

I am looking to get a rhinoplasty within the next 6 months. My nose is too wide and overprojected, and my nostrils are large and upturned. No definition, bulbous tip. Any advice is greatly appreciated! Not sure if just tip should be narrowed or the bridge as well (osteotomy)? The tip needs a lot of narrowing. Are there any limitations to this? I want it to be no wider than the top of my bridge, as currently my nose widens significantly as it goes down from the top of the bridge. ...

Doctor Answers 12

Large, Over Projected Nose

With the multiple issues you describe I recommend that you have a full rhinoplasty with reduction of the size of your nose, a decrease in tip projection and width, and a septoplasty to straighten the deviation which is visible on the base view. There are limitations because you want to establish good proportions between the different parts of the nose to achieve a natural result.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Male Rhinoplasty Evaluation

Your visual perception of what your nose needs is right on. The main problem is with your tip which is over- projecting, large but not particularly bulbous. You are correct in your evaluation of the tip cartilages and their width. The challenge with your nose is typical for male rhinoplasty;  controlling your tip projection is important so that your bridge can be altered to fit a less projecting tip. You radix is strong and shouldn't be altered. The bridge being altered means you will probably need osteotomies of some variety. Letting your tip settle will further widen your nasal base which will require alar resections. I see no compelling reasons to do an "open" rhinoplasty with a scar across the columella. Remember, regardless of the Plastic Surgeon you choose it will be at least 6 months to begin postop evaluation of you result. Choose you Board Certified Plastic Surgeon well- the first operation is the golden chance to get it just right!

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon
5.0 out of 5 stars 7 reviews

Large,bulbous nose problems.

Remember that the final result of any Rhinoplasty is dependent on the texture, thickness, etc. of overlying skin. In some patients the skin is very thin and will show the delicate anatomy and  beauty of the underlying nasal cartilages enabiling the surgeon to carve the cartilages to show off the delicate facets of a finely defined nose. In some patients however, with thick, porous, oily skin  the surgeon could remove all of the cartilage and the nose would just sit there unchanged. It is similiar concept of a pup tent made out of silk or heavy canvas. The skin will determine the end result of attempts to narrow the tip.   

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 55 reviews

Rhinoplasty for Wide Nose, Bulbous and Overprojected Tip, Large Upturned Nostrils, Possible Septoplasty? Opinions Please?

Dear Be,

Thank you for your question and photos.  I definitely agree with most of your assessment.  Decreasing the projection and width of the nose, refining the tip, and slight lowering of the tip are all parts of a successful rhinoplasty for you.  The tip rotation is especially important.  A male tip should be at or close to a right angle to the lip.  A more feminine tip has a softer angle with a slight upward rotation.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Rhinoplasty for Wide Nose, Bulbous and Overprojected Tip, Large Upturned Nostrils, Possible Septoplasty? Opinions Please?

       The tip can be narrowed and deprojected.  The dorsum can be narrowed as well as the alar base.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions 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

Need larger photos!

From the photos you posted, you might be right about your assessment, but the photos are much too small to give any detail. Please post photos that are substantially larger. I could give you an assessment, and make a couple morphs to show what a reasonable goal from rhinoplasty would be.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

Rhinoplasty suggestions

I agree with your comments. i would add that it looks as though you might have a deviated septum as seen from below. This might be contributing to some mild asymmetry in the tip. Also, your nostrils may be a little weak (slight notching seen from below) such that changing the tip may cause an issue unless dealt with at the time of surgery. Otherwise narrowing your bridge a bit and tip-plasty as you describe should be included. Good luck.

Candidate for a rhinoplasty

You appear to be a good candidate for a rhinoplasty.  This would involve a reduction of the nasal tip as well as a derotation of the tip to decrease tip projection.   The base of the nose needs to be narrowed with a lateral osteotomy.   

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Rhinoplasty for the wide the wide nose, which is overprojected etc.

Rhinoplasty for the wide the wide nose, which is overprojected etc. needs a very experienced rhinoplasty surgeon so your short nose is not made shorter while the surgeon does tip work. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Rhinoplasty for overly projecting nose and bulbous tip

 The bulbous tip is best addressed by suturing the tip cartilages together and conservative removal of cartilage.   Decreasing the overall projection the nose is accomplished by shaving down the dorsal septum and reducing the projection of the tip cartilages themselves. Wide nostrils are  narrowed with an alar-plasty.  Please see the link  below for examples of noses similar to your own from our rhinoplasty  photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 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.