What to Do with This Bulbous Nose? (photo)

Hello,

It is possible to make the tip smaller and more defined during an open rhinoplasty surgery. However, patients with thick skin may not always achieve the level of definition they desire. In addition, swelling may linger for a longer period of time with patients that have thick skin. The final result of surgery will not be evident for up to 24 months following surgery.  The width of the nose can be reduced with osteotomies. Thank you, and I hope this helps answer your questions.

Dr. Nassif

Based on your photos it appears that you have prominent and convex alar cartilages which can be reshaped and sculpted with rhinoplasty.  You also have thick skin which needs to be taken into consideration

It is impossible to fully answer your questions solely on the basis of your limited posted photos. The area you outlined is called the ala. The dome of the tip in the third photo is broad and that can be narrowed by suturing the 2 C-shaped tip cartilages together. If the nostril rims are more than 3 or 4mm in width they can be narrowed by removing fat from within the rim. The nasal width is assessed by comparing it to other facial structures but those are not included in your posted photos.


I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Excessive width of the nose and a bulbous nasal tip can be refined with #rhinoplasty. Seek an expert. Rhinoplasty is commonly performed but is the most challenging cosmetic procedure. Because of this, you want to find a rhinoplasty expert who has the best chance of giving you a pleasing result while maintaining your breathing the first time around. Seek a Facial Plastic Surgeon or Plastic Surgeon with board certification and alot of rhinoplasty skill. Look at photos of their patients' results. Ask them to "morph" your pre-operative images to ensure that you are both on the same page. This is not a guarantee of results but is a communication tool that ensures that you are both seeking to achieve the same result. Thank you for your question. Stephen Weber MD, FACS

Cartilage width and skin thickness typically add to a wide or bulbous nose.

A tip plasty including suture refinement as well as cartilage reduction in the area above the tip defining point will result in reduction of volume. This is a fairly standard operation for any surgeon that does a lot of nasal work. If your skin is too thick or the cartilages are soft, then cartilage grafting may be required to add structure and definition to the tip.

The volume in the nostrils can be slightly reduced. However, there is no specific structure that can be shaved or modified in that area. Some thinning of the fibrofatty soft tissue can be done. However, predictions about result are difficult in that region of the nose.

Best of luck