How do you know what's doable as far as airway constriction? How much dorsal hump reduction & restructuring possible? (Photos)

I asked a similar question just days ago, but today I edited my nose from a profile view to what would really be my absolute ideal. I want to know if it is even possible with my nasal passageways?

Doctor Answers 10

Rhinoplasty Candidate

Dear barc3candi, Your morphed results look like a very reasonable and attainable result. When I perform rhinoplasty procedures I always address both function and aesthetics as a beautiful nose should be a well functioning nose as well. In the hands of a skilled surgeon you should not have any compromise in your breathing. Seek some consultations by expert surgeons and review the before and after photographs to ensure natural looking rhinoplasty results. See examples in the link below and video above. Best regards, Michael V. Elam, M.D.


Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Rhinoplasty candidate for dorsal hump removal

A rhinoplasty procedure can accomplish shaving down the dorsal hump as in the digitally altered photographs.  The nose is a 3-dimensional structure, so computer imaging can be performed from the different angles to give an idea what can be accomplished with the procedure.  The digitally altered photograph does appear realistic, by an experienced rhinoplasty surgeon.  It is also important to evaluate the internal nasal passageway, so as to not create any breathing issues after the procedure.  For more information and many  before and after examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Rhinoplasty Goals

Your morphed result is very reasonable.Computer imaging can help a patient decide what they want to achieve but I feel it is equally as important to ask for examples of actual results in patients who had a nose like yours. The airway should not be compromised after a cosmetic rhinoplasty.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

May I alter your morph just a bit?

See the "Web reference" link, just below my response. I made my own 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.

Besides lowering the bridge, I also elevated the tip of the nose a bit, and brought the entire nose back a little closer to your face. As you pointed out in your other post, it would also be important to narrow the tip of the nose.

When a bump is taken off of the bridge, it can make the nose look like the tip dropped, so it's usually important to elevate the tip some. Then, bringing the entire nose back closer to your face can help make it look smaller, and you've been wanting a smaller nose.

In the animation, you'll see that I took care to lower the bridge up high, just in front of your eyes. You mentioned that you have a "Roman" type nose, and if that area isn't lowered at the same time that a bump is taken off, then the nose can start to look like a Roman statue's nose, with the forehead sliding right down onto the nose, without that little dip in the profile at the top of the nose, under the eyebrows.

Airway considerations can be addressed at the same time as the rhinoplasty.

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 "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.

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 a beautiful nose, and whether he shares your opinion of what constitutes a beautiful 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.

I usually make a morph when I'm answering questions like this, but you are talking to otherwise moving your face in the photos, and none is good for making a morph. Sorry. See the "Web reference" link, just below my post. At the *very* bottom of that page is a link to instructions on taking photos that are most useful for online consultations like this.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

How do you know what's doable.

One of the best ways to see what is possible after rhinoplasty is computer simulation by the surgeon. We know there are apps available you can experiment with, however your surgeon's use of professional software offers the best guide to see what is doable during rhinoplasty.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 40 reviews

Rhinoplasty

You have detailed a pretty standard dorsal reduction.  This should not affect your nasal passages.  I would add a slight reduction in tip projection as well.  This result should be attainable.  Best wishes, Dr. T. 

Dorsal Hump Reduction and Airway Contriction

Thank you for your question.


Based on the picture, that amount of dorsal hump reduction would very likely be possible in your case.  It's not possible to know about improving the airway without an examination of your nose and the ability to look on the inside to see what may be the issue.  I recommend you consult with several local/regional surgeons with extensive rhinoplasty experience to discuss your options.



Best,


Dr. Michael Epstein


MAE Plastic Surgery


Northbrook, IL

Expert advice in person needed

Based on the photo it looks likely that your profile adjustment will be achievable close to what you have done but you must see an experienced rhinoplasty surgeon in person so they can check your airway and see and feel your nose - any changes must result in a better shape but also maintain or improve function and even make your nose stronger structurally 

Technology may be your answer

This is certainly possible, but, of course, and individual consult is necessary to assess the nasal valve and airway.  Newer technology (the Spirox) may improve your results.

Gregory S. Keller, MD, FACS
Santa Barbara Facial Plastic Surgeon
4.9 out of 5 stars 12 reviews

Never compromising function with rhinoplasty

A well-performed rhinoplasty will never compromise function for aesthetics; in face, many times airway flow will be greatly improved when you have deviation of a septum, a narrow internal angle or large turbinates (humidifiers of the nose).  The simulation you have provided is reasonable; seek out a Board-Certified plastic surgeon who will accurately examine the external AND internal structure of your nose and create a plan that suits your needs and wishes.

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.