Bulbous low nose when smiling - how to fix? (Photos)

Thanks for your question and photos. For refining the tip of the nose, either a closed or open (my preferred method to get maximum control of symmetry) tip rhinoplasty can be performed which refines the bulbous area with minimal scarring.   An open technique allows better visualization and control of the paired cartilages which act in conjunction to define your tip shape and symmetry.  The ability to see both cartilages simultaneously and work on them together allows the surgeon ultimate control over both the shape and symmetry and, of course, beauty of the nose. Make sure you see a board certified plastic surgeon and look very carefully at their before and after photos of other patients. Computer imaging can be a useful tool as well but don't solely rely on that when making your decision.

Hello and thank you for the question.  It is difficult to fully assess your nose from the photos, however a bulbous tip is a common complaint.  There are a variety of techniques to address this issue.  The majority of these techniques involving re-shaping the cartilages that comprise the tip to give the tip a more narrowed, aesthetically-pleasing appearance.
Also, when the tip descends with smiling, this is known as the smile deformity.  This is also a correctable issue, that has to do with some of the muscles around the tip.
If these issues really bother you I would recommend seeking a consultation from a board certified plastic surgeon or facial plastic surgeon who has expertise in rhinoplasty. During your consultation be very specific as to your concerns and have an open and honest discussion regarding the best way to correct them.
Hope that helps and good luck!

Thank you for your question. All of us have features that can have a negative effect on our self-esteem. There is nothing offensive about your nose but it is out of proportion with the rest of your face. You should see a surgeon who can do computer imaging for you. That way, you can see what is realistic based upon your anatomy.Best wishes.

Large tip cartilages, extra fat between the cartilages or excessive thickness of nose skin can make the nose tip to look bulbous. Regardless, it is correctable through limited rhinoplasty. You may consider consulting a plastic surgeon experienced in nose surgery.Good Luck. 

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 cephalic rotation of your tip to turn
up your tip slightly.  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.
Harvard-trained plastic surgeon

Hello Melissa and thank you for your question.  It is difficult for me to appreciate a significant bulbous look to your nose in your photographs.  The classic bulbous nose description entails a wider nasal tip than you have.  I would recommend an exam in person with a plastic surgeon in your area.  In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details, if indeed you would benefit from one.   These details would include the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.  In terms of your breathing function, an exam in person will allow your plastic surgeon to evaluate whether a septoplasty would benefit you as well.And lastly, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.For more information on rhinoplasty, please refer to the link below.Good luck.Mark K Markarian, MD, MSPHHarvard-trained Aesthetic Plastic Surgeon

Based on the photo, you appear to be an excellent candidate for rhinoplasty. However, you do have some options. Consult in person with an experienced and expert board certified plastic surgeon to understand your options.

  To reduce the bulbous tip requires suture techniques, cartilage grafting techniques, and a conservative cartilage removal applied to the lower lateral cartilages of the nasal tip.  That will narrow the tip from the frontal view.  If the tip of the nose droops when smiling from the side view, then releasing the depressor septi ligament will  prevent that from occurring.

All noses widen with smiling. If you are unhappy with the shape , then you should be seen in person for a rhinoplasty evaluation.  Good luck.

Every nose is
different and unique to that individual. If the appearance of your nose
concerns you enough to do something about it, it can be improved with a natural
artistically performed rhinoplasty. What would be the best option and exact
procedure would depend on an in person examination (not just an online
consultation) and discussion about desired outcome. Excellent results can
be achieved with either a closed or open technique.
Keep in mind that following advice from a surgeon on this or any other website
who proposes to tell you exactly what to do and how technically to do
it based on two dimensional photos without examining you, physically
feeling your tissue, assessing your desired outcome, taking a full medical
history and discussing the pros and cons of the operative procedure would not
be in your best interest. Natural appearing results need to be individualized
and what is appropriate for one patient is not necessarily the best for someone
else. I would suggest that you find a surgeon with extensive rhinoplasty
experience certified by the American Board of Plastic Surgery and one who is
ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that
surgeon in person.
Robert Singer, M.D., FACS
La Jolla, California