Scared of my rhinoplasty being noticeable? (Photo)

Question

I have a consultation today with a doctor. I want a very subtle rhinoplasty for my dorsal hump. But I am so scared of people noticing, my nose looking “sculpted” or it turning out too upturned, etc. I am seriously terrified because it is an irreversible surgery. I am also scared of people noticing which is the last thing I want. Do people usually notice or am I just overthinking this way too much? Is it possible to do a natural looking rhinoplasty on my nose without looking totally different?

Deepak Raj Dugar, MD · Answer

Hello!If you are concerned about it looking like you got something done, I would suggest looking into a closed rhinoplasty. There are no scars or external cuts, people will not know you had anything done. With a closed rhinoplasty you can make subtle refinement without looking "overdone". I recommend closed rhinoplasty for primary rhinoplasty, meaning they haven't had previous work. The healing process is a lot quicker, you typically feel back to normal from day 2 onwards. The cast comes off on day 5-7 with minimal bruising, if any. Consult a surgeon that specializes in closed rhinoplasty to determine if you are a candidate.

Steven M. Denenberg, MD · Answer

Click on the "Learn more" link, just below my response, or go here:
FacialSurgery.com/RealSelf/RealSelf_grace98.html
I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands.
Here's the deal: you have a bump on the bridge of your nose, and the nose is very strong in its forward projection from your face. The woman in the short video I posted with this answer had a strongly-projecting nose.
If the bump is lowered, and the tip brought back toward your face, those changes make the nose *look* longer, as if the tip dropped, so we elevate the tip (to the patient's taste, of course), to offset that factor.
If you have tiny tiny changes, leaving the strong projection, and leaving part of the bump, sure, nobody will notice, but that's a lot of work and risk to go through for no results. Also, my patients who insist on tiny changes in noses that need more, usually wish later that they had done more to their noses. If you're bothered because your nose is too big in some dimensions, then don't have the surgery unless your plan is to get the nose so it's *not* too big in those dimensions, or after surgery, when it's still a little too big, it'll seem like, "why did we do this?"
What most people are happy with, is a nose that looks natural and has good proportions to their face, and is an attractive nose for them. If that's a big-ish change from their original nose, well, that's okay, too. Don't leave yourself with a nose you still don't like, just so that other people don't notice. My two cents.
You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon. You should only have surgery if you are able to make yourself very confident in your surgeon's skills. Read that page very carefully. Most plastic surgeons are quite poor at this operation, and I believe my advice will go a long way toward keeping you safe.
I'd love to hear what you think of the morph. Did it seem to address some of your main concerns? Maybe I did a little bit too much with the morph? It doesn't have to be de-projected quite that much, or upturned quite that much, but I wanted to show you how we name those changes. I can make another morph if you like.
Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who understands all of the issues I mentioned, and how they fit together, and who can actually accomplish them in surgery.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a conservative dorsal hump
reduction.  This can be designed to have a natural appearing result.  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

Matthew Bridges, MD, FACS · Answer

The best thing you can do is discuss your concerns with your surgeon.  Have you carefully examined his before and after photos?  Hopefully you have not seen any results that concern you in terms of too dramatic a change.  Make sure you know what techniques will be used on your nose.  At the end of the day, the surgeon's artistic sense comes in to play.  Make sure you like his part work.  Good luck!

Omar Fouda Neel, MD, FRCSC, FACS · Answer

Hello and thank you for your inquiry. Your concern about wanting a subtle rhinoplasty is a popular one that you should emphasize with the plastic surgeon of choice. Keep in mind that a subtle result is very obtainable but that your close friends and family, even your acquaintances may notice. The removal of your dorsal hump is noticeable and troublesome to you which is why you want to undergo a rhinoplasty and the result will be impactful enough that you notice but subtle enough that it will not look overdone. The nose being the forefront of your face, people may take notice, especially when looking at your profile. However, this should not scare you. Ask your board certified plastic surgeon many questions and request to see his work on previous patients. Before and after pictures of subtle changes can be helpful and ask if he or she can take a 3D image of yourself with the new nose. Go into this with an open mind and do your research well on what to expect post-op. Once the swelling goes down, within a few months, you will not pay heed to anyones thoughts and or curiosity.  What is important is that you feel great with the decision you made. In  hopes this has helped answer your question Best Regards.

Ziyad Hammoudeh, MD · Answer

For the first 2 weeks after rhinoplasty, your nose and lower eyelids will typically be very swollen and bruised that people around you will notice.  After 2 - 3 weeks, you will be "restaurant ready," meaning you can walk into a restaurant and people who do not know you will not look at you as though you had something done.  It takes a full year for all of the swelling to completely resolve after rhinoplasty and to see the final result, but the swelling improves quickly over the first few months.  Long-term, the noticeability will depend on the extent of the changes performed and how well the people around you know you.  Subtle changes in which a better version of your nose is achieved often go unnoticed by others.  Close friends and family members that know you very well may be able to notice that your nose appears different, especially if dramatic changes are to be performed such as a large hump reduction.  People that are more of acquaintances and do not know you well may not notice.  A very natural result is a very common request that can be achieved.  I would recommend discussing these details with your surgeon before surgery so that your specific expectations can be better addressed.  Good communication between patient and surgeon is very important both before and after surgery.
Ziyad Hammoudeh, MD

William Portuese, MD · Answer

It's important to remember that it takes several months for all the swelling to subside in the nose, so there is no dramatic and immediate change after a rhinoplasty procedure. It's very rare that someone detects that you had a nose job. In our practice, the before-and-after photos are taken several months apart.

Steven Wallach, MD · Answer

I think that certain people will know that you have had a rhinoplasty, especially close friends and family.  If subtle work is being done, it may not be noticeable to others.

Rick Rosen, MD · Answer

Yes, is the short answer. The surgeon should be able to do subtle changes in your nose, that will look very natural. Discuss your concerns with your surgeon and do your research into their results before you make your final decision.

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