Are the Rhinoplasty results I'm hoping for attainable and would it take a very highly skilled plastic surgeon? (Photos)

I have a very bulbous tip, I just want it to be less wide but don't want to change the overall shape of my nose. I used photoshop on my picture to give an idea of the desired look! I've been wanting a rhinoplasty for a while now, but im terrified my nose will be messed up. Most before and after pictures of rhinoplasty I see are taking a bump off the persons nose and not really re-shaping the cartilage so I'm worried that I may pick the wrong Doctor that only has that sort of experience!

Doctor Answers 11

Desired rhinoplasty results

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Subtle contouring of the nose or tip can be done but if very little is done the change may not be very noticeable or could have a negative impact on the overall appearance.  You have demonstrated subtle contouring of the nasal tip width where the tip was brought in more on the left side and the end result makes a slight asymmetry in the upper and middle thirds of the nose (where it deviates to the right) more noticeable.  As in your photoshop example making changes in one part of the nose impacts the overall appearance of the nose - what should perhaps seem very simple is often more complex.  You need a surgeon who is comfortable with addressing asymmetry in the upper and middle thirds of the nose and with cosmetic changes to the nasal tip.  VECTRA 3D imaging is a useful tool that can ease that "fear of the unknown" by showing realistic simulations before the surgery is completed.  

Bulbous tip

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Correcting a bulbous tip is a standard procedure in all rhinoplasties.  You would benefit from reduction and suturing together of the tip cartilages and possibly some cartilage grafts.  Best wishes, Dr. T

Rhinoplasty to address a bulbous tip

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Thank you for your question and for posting photos. Rhinoplasty can absolutely refine and narrow your tip. This may be done with incisions limited to inside the nose (endonasal rhinoplasty) or with incisions on the inside and outside of the nose (external approach rhinoplasty). An external approach will use an incision on the columella, which is the middle part of the nose, below the tip and in between the nostrils. This incision heals beautifully and when performed correctly will heal with a barely visible scar. I prefer an external approach, as this allows the best control of the tip cartilages, allows the best options for cartilage grafting should it be necessary, and will ultimately give the best results. You should most definitely seek out a board certified facial plastic surgeon or plastic surgeon who is very experienced in rhinoplasty. Best of luck!

A closed rhinoplasty is effective, safe and with no visible scars

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Your bulbous tip can be treated very effectively with a "closed" rhinoplasty technique. This involves incisions on the inside of the nostrils and avoids a visible scar across the columella (the central column beneath the tip).  In your photoshopped photo, the entire length of your nose appears narrower and so it seems to me that you feel that it's no only your tip that is widened.

I'd need to see your profile photos in order to determine what techniques I would utilize to narrow the shape: for the tip, trimming of the bulbous cartilage, and then placement of cartilage grafts at the tip to create better projection which also narrows the tip; for the middle, a cartilage graft to raise the bridge which gives the illusion of narrowing; and for the upper nose, possibly osteotomies (controlled bone breakage) and narrowing of the nasal bones.

Of course, an in-person examination is key to determine the best approach and, as with any surgery, a consultation with a board certified plastic surgeon with experience in rhinoplasty is crucial. 

All the best in your search!
- Dr. Rad

What can be done for my nose?

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Thanks for the very good question.  As you may have learned, rhinoplasties may be very difficult to predict as to how the shape may be after the healing has occurred.  Always try to choose a surgeon who can discuss the  possibilities of modifying the current shape of your nose to give you the shape you might prefer.  This may not always be possible, but a very important part of a consultation should be to describe to you  what you might expect to see.  A more thorough rhinoplasty may be required to give you a better result, but this  could only be determined after a thorough examination.

Good luck to you.

Frank Risger M.D.  Tampa Plastic Surgeon

Would it take a very highly skilled plastic surgeon?

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The answer to both of your questions is yes.

You are an excellent candidate for a rhinoplasty to address the concerns you detailed above. But rhinoplasty is a technically challenging operation; do your homework and seek out a consultation with a Board-Certified Facial Plastic Surgeon or General Plastic Surgeon who has experience with rhinoplasty.

Best wishes!  Harry V. Wright MD, Sarasota, Florida

Harry V. Wright, MD
Sarasota Facial Plastic Surgeon


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In order to evaluate most accurately - you would need a good physical exam. Also, when submitting photos- it is helpful to have all views of the nose- frontal- which you have, profiles and the view of the nostrils. From the one photo- it appears that you would benefit from Rhinoplasty to make your nose more elegant and smaller. It is very important that you seek a highly experienced and Skilled Board Certified PS, look at his/her before and after photos before you set up your appointment. Hope this helps


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A manipulation of the tip cartilages can often give refinement to the tip, making it less bulbous. It works best with thin skin and strong, broad alar cartilages
If your tip cartilages are weak and or thin, then there is little that can be done by that route.
Only after consultation, an expert in the field, can give you an accurate appraisal of what to expect after susrgery.

Rhinoplasty for the Bulbous tip

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 A rhinoplasty procedure can accomplish narrowing the bridge line and narrowing the bulbous tip. To narrow a significant bulbous tip usually require suture techniques and conservative cartilage removal applied to the lower lateral cartilages of the nasal tip. Look for a surgeon who has dedicated a significant component of their practice to the discipline a rhinoplasty, has a large photo gallery of rhinoplasty patients, and is board certified. For more information about  bulbous tip reduction, please see the link and the video below


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Thank you for your question. Not only are the results you are looking for attainable, but many facial plastic surgeons pride themselves on their ability to reshape the tip. In fact, the tip is very important to the overall aesthetics of the face. The most ideal angle between the nose and the upper lip, also called the nasolabial angle, should be between 95 to 110 degrees, and works in concert with the size of the nasal tip to shape your appearance.

I suggest that you consult with a board certified facial plastic surgeon. You should seek facial plastic surgeons with great testimonials, phenomenal before and after photos, deep experience and exceptional education/training. Your rapport with the surgeon is of the utmost importance as well because you will be interacting with the surgeon well before and beyond the surgery itself.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 123 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.