Is my nose able to get a nice nose job? (Lack of cartilage) (Photo)

Question

My whole life, my party trick is me being able to push my nose down to be completely flat. I don’t know if this is due to lack of cartilage or bone, or both! I want my nose to have more shape, because I feel that the bridge is so wide/ non excistant. I would also want the profile to be nicer. I have included a photo of my dream nose (I know it is unrealistic to ask that, but it is just to give an idea) look at her bridge! (Last two photos are the ideal/ close to what I want)

Philip J. Miller, MD, FACS · Answer

I would recommend starting with a consultation with a board certified facial plastic surgeon that specializes in rhinoplasty surgery to discuss if rhinoplasty can address your concerns. 
I would recommend writing down the following questions before scheduling your consultation:
1. Are you unhappy with the tip of your nose? 
2. Do you feel that your nose is too wide? 
3. Do you want to make your nostrils smaller in appearance? 
4. Are you looking to decrease the general size of your nose?
I hope some of these questions will help you pinpoint what it is that you don't like about your nose.  Cost will vary due to many factors including: facilities fee and anesthesia fee. I wish you the best as you research your options when scheduling a rhinoplasty consultation.
Sincerely,
Philip J. Miller, MD, FACS Double Board Certified Facial Plastic Surgeon

Eric M. Joseph, MD · Answer

The two profile photos of your nose are not adequate for determining your candidacy for rhinoplasty. You may have a short nasal septum which may allow you to flatten your nasal tip. An examination of the strength and amount of septal cartilage you have in your nose would be necessary. Consider consulting with several rhinoplasty specialists so you could see what might be best for you moving forward. Hope this helps! Dr Joseph

Damien Grinsell MBBS, FRACS (Plast) · Answer

Hi LilyWhilst your photos you have sent through are a little hard to see, it does seem like there are multiple features of your nose which could be corrected with a rhinoplasty.  Commonly we use cartilage from inside the nose to support or correct elements of the nose that are weak or missing.  This would be suitable in your case.  I would suggest you meet with a competent rhinoplasty surgeon to have a consultation.CheersDamien

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. You may also benefit from a columellar strut graft to help support your nasal tip.  Make
sure you specifically look at before and after pictures of real patients
who have had this surgery performed by your surgeon and not just a computer
animation system. The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

John Layke, DO, FACS · Answer

Although you may lack the septal support giving your nose shape and definition, you are still a candidate for rhinoplasty.  Many times a lack of support simply means that the surgeon must acquire cartilage from another area, such as ear or rib.  This allows a structural framework to be created to give you a more defined, chiseled appearance.  Consult with a Board-Certified plastic surgeon who will accurately examine you, create a 3D simulation, and develop a plan tailored to your needs.

John Michael Thomassen, MD · Answer

A rhinoplasty to narrow your bridge with nasal bone osteotomies, and reduce the dorsal hump slightly as well as tip refinement to reduce and suture together tip cartilages should do the trick.

Ronald Schuster, MD · Answer

I think you have reasonable goals. You will need cartilage grafting which can be done in a variety of different ways. Make sure you choose an experienced rhinoplasty surgeon for your best chances to get it right. Good luck.

Kian Karimi, MD, FACS · Answer

This is a great question! Noses are a beautiful facial feature that can determine overall facial harmony. A rhinoplasty procedure can correct any disharmonious nasal features to beautifully achieve the aesthetic results you desire that effortlessly compliments the remaining facial features. With a rhinoplasty, the procedure can raise the bridge of your nose and redefine the shape of your nose for a beautiful profile. When consulting with an aesthetic provider, be sure to do your research: visit the board-certified facial plastic surgeon's website and view before and after photos to ensure the results previously delivered are in line with your aesthetic goals. Thank you for your question and good luck! Dr. Kian Karimi

Jonathan Kulbersh, MD · Answer

Your nose could be improved with rhinoplasty, which would give permanent improvements in symmetry and shape. You can bring the photos of noses that you think would be flattering to your face and these can be discussed. When you meet with a facial plastic surgeon, he or she will consider your nose in balance with your other features. I hope this helps

Peter Callan, MBBS, FRACS, MBA · Answer

Hi there Lily.  What you describe is a normal variant, in other words many people can do this!  It just means your cartilage is not a thick and robust as many others have, but the cartilage will be there.  It is probably a little on the thinner and more flexible side and you may have a smaller nasal spine (small piece of bone that the cartilage rests on).We can always add cartilage to a nose with rhinoplasty. There are many places we can get it, but deep within the nose in the septum (which cannot be seen when taken) is the commonest.  The main determinant as to how your nose will go with rhinoplasty is how compliant and thick the skin is.  The skin covers everything underneath. With thin skin you can see the underlying structure easily as in the last photo you show.  Thicker skin needs more work underneath to give pleasing proportions.Yours is by no means an easy rhinoplasty.  You need to see an experienced rhinoplasty surgeon, but change and improvement is definitely possible in good hands, if that is what you wish.I hope this helps.

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