Rhinoplasty results for bulbous, upturned nose unpredictable? (Photos)

Question

Have read that bulbous noses are hard to treat & results are particularly unpredictable. Main concern is how large nose is from front and wide nostrilsnostrils from side. Seems to be ridge on tip of nose + tip feels upturnedupturned+hard. Have slight deviated septum + polyps present on MRI & want to handle these issues too. Worth getting rhinoplasty or too risky for my nose type? Can I do chin implant first and rhino at later date without compromising over all facial assemetry?

Ozge Ergun, MD · Answer

Dear abigailgarnicaThanks for the question. It’s not easy to comment based solely on one photo but it’s possible to restore the symmetry of your nose and front view. Probably it will be 2 hours surgery under general anesthesia and basic recovery time will be 10-14 days. I wish you all the best.

Michael Kulick, MD, DDS · Answer

Yes, significant improvement can be obtained with a rhinoplasty regarding your nasal tip. Click on the web link below, go to the photo gallery and look at case # 2889, 2855 and 2543. If you are looking at a combination of rhinoplasty and chin implant which is very common go to the rhinoplasty site and look at the combination procedures. The septum can be addressed and perhaps the nasals polls. For sure bring in your MRI results at the time of your consultation. You are doing the right ting s so that you are not a "re-do" rhinoplasty patient!For sure you need a face-to-face consultation to deal with all of your issues.Sincerely,

Michael Kulick MD

   Board Certified Plastic Surgeon, San Francisco Ca
   Member of ASPS, ASAPS
   Recipient of the Klingbeil Award – Teaching Safe Techniques and Advanced Technologies

Michael Kulick MD

Board Certified Plastic Surgeon, San Francisco Ca
   Member of ASPS, ASAPS
   Recipient of the Klingbeil Award – Teaching Safe Techniques and Advanced Technologies

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. You seem like a good candidate for rhinoplasty so I suggest that you move forward and consult with a board certified facial plastic surgeon. It is important that your nose has a shape and size that is both proportional and symmetrical to your face, while also having good function.
Best wishes,

Zoran Potparic, MD · Answer

Based on your photos it seems that you are good candidate for rhinoplasty. I see no reasons for concerns regarding desired improvement. Whether you may need a chin implant or neck shaping (neck lift vs. liposuction) would be sufficient to correct visually smaller chin, can be determined only on the basis of in person evaluation. Consultation with a board certified plastic surgeon with good reputation in nose surgery and facial rejuvenation is recommended. Good luck.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photographs, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. Septoplasty can be performed at the same time.  A chin implant and submental liposuction can be performed at the same time for
improved jaw line contour.  I always use a medpor implant with screw
fixation, which stays in place over time.  A silicone chin implant has a
high rate of malrotation over time.  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

Evan Ransom, MD, FACS · Answer

Thank you for the question and the photos. You bring up some good points here. Reducing the tip volume can be done without changing the tip position or rotation. However, decreasing rotation (lowering) the tip can be challenging and requires special cartilage grafts (septal extension). In my practice, I use this technique frequently for so-called ethnic rhinoplasty. The limiting factor is generally the size of the skin envelope— but if you are reducing tip volume, this is generally not a problem. Regarding your functional issues (polyps and septal deviation), there is no reason that these could not be handled at the same time. For the chin, I would recommend doing this at the time of the rhinoplasty to make sure the proportions are correct. Take care!

Jonathan Kulbersh, MD · Answer

Bulbous noses can be improved with rhinoplasty. You can bring the pictures that you think would be flattering to your face and these can be discussed.  It takes special interest and study to understand the facial aesthetics to create a nose that is harmonious with your other features. Take the time to find the right facial plastic surgeon and ask them to create digital images of the nose they propose for you and discuss the cost.
Hope this helps.

Jeffrey Jumaily, MD · Answer

Bulbous tips are common concerns and I treat it in almost every rhinoplasty patient. Most patient require some type of tip refinement. I don't consider it more unpredictable than any other part of a cosmetic procedure. You can definitely have the septum and polyps treated at the same time as the rhinoplasty. The chin implant can be done before, after or at the same time as rhinoplasty. Consider a consultation to have your questions answered. Best wishes

William Portuese, MD · Answer

A closed Rhinoplasty approach can accomplish reduction of the bulbous nasal tip with suture techniques and conservative cartilage removal. Functional endoscopic sinus surgery is performed when there's polyps noted on a CAT scan, not an MRI. A septoplasty is only performed in the back of the nose to improve airflow, if that is symptomatic and significant, and is not performed  when it is only slightly deleted. Consider placement of a small chin implant at the same time as the rhinoplasty procedure to augment the chin forward to help  with facial balance and proportions, especially with respect to the side profile and projection of the nose. Look for a double board certified ENT/facial plastic surgeon who can address all of the functional and cosmetic issues with regarding your nose in addition to the chin implant. For many before-and-after examples of this combination along with more information about functional  endoscopic sinus surgery, please see link and the video below

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photos and question and I would go on some complimentary consultations with experts who use digital photography to show you what can be accomplished and how it might be done.  Then look at photos of similar patients and become fully informed about the desired procedures Dr Corbin