What can I do to improve my side profile? (Photo)

Question

I am considering both a rhinoplasty or jaw surgery. Rhinoplasty would be to straighten the bump on my nose but I am worried it will make my face look very flat due to my recessive jawline and slight overbite and I do quite like my nose from front on as it is defined. However I think jaw surgery is more expensive and dangerous? Which would be recommended to improve my side profile?

Steven M. Denenberg, MD · Answer

I'll get to the jaw surgery later. There are a number of changes that can be made to your nose to make you more comfortable with it. There's the bump, of course, and that can be lowered. Your nose is also long, meaning it looks in some views as though the tip is drooping down more than it needs to. As is typical, the nose looks longer in the three-quarters view than it does in the profile or frontal view.Also, when you remove the bump from a bridge, that alone makes the nose *look* longer, so on your nose it'd be very important to shorten the nose by elevating the tip.Then, the whole nose can be brought back a little closer to your face. That would help make the chin look a little stronger, too, because it wouldn't be overpowered by the nose.Something else:It seems that your bridge is strong up at the top of the nose -- in front of your eyes, or just below your eyebrows. When the nose is strong there, if a large bump is removed, it's important to reduce the strength of the bridge up there at the top, or your profile would resemble the profile of a Roman statue, where the profile of the forehead slides right down onto the nose, without that little dip we like to see in front of the eyes. Search for Roman statue profile to see what I mean. Your surgeon must pay attention to that, too.
How *much* to elevate the tip, or deproject the nose, or lower the bump? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should always be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and only the surgeon has that information and judgment. Another aside: I also recommend that you not show morphs made by one surgeon to a different surgeon. If a surgeon makes his *own* morphs, you get to see whether he understands the important issues of your nose, and how your nose should be changed. But if you show the surgeon someone else's morphs, and he says "Of course I can make your nose look like that," then you don't really know if he fully understands, or even recognizes, the important changes shown in those morphs. And you don't know if he can make those changes during surgery.)Here's the caveat: Your surgeon really must understand and pay attention to all the areas I described. If only some of them are addressed, you might like your nose less than you do now. For example, if only the bump isn't removed, and the tip is not elevated, your nose probably would look very long.
Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.
Your nose is also a perfect example of why computer imaging by the operating surgeon 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. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, 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 large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?The jaw surgery: it's a complicated operation with lots of potential problems. It's best done for someone whose teeth fit together so poorly that it's hard for them to eat. It's done for a cosmetic change only if the cosmetic change would be *gigantic -- not just a recessed chin. It's to be avoided unless you really need it.It could be possible to do a small chin implant, and that might help -- morphs would tell. Also, remember, if a great job is done on your nose, your chin probably wouldn't bother you afterwards. A big nose (no offense) makes the chin look weaker than it is.

Lucian Ion, FRCS · Answer

The best way to get an answer to your questions in to have some computer simulations that reshape the front and profile of the nose. This can give you clarity regarding what you feel looks good for you.For the chin contour a slight augmentation seems potentially beneficial, and of course there are alternatives of using jaw surgery to this effect. Jaw surgery is in a situation like yours would be justifiable only if there are problems of the bite. This is an area where maxillofacial surgeons can advise you.In a computer simulation in 3D you can also evaluate better the impact of a chin augmentation which can be carried out using implant or through a genioplasty. Injectable fillers to the chin are a temporary way to understand the impact of chin augmentation.

Peter D. Hodgkinson, FRCS(Plast) · Answer

It's not uncommon for me to see patients like you who wish to rebalance their profile.  An open rhinoplasty addresses the shape of the nose.  As far as I can tell it should be possible at the same time or later to bring forward and probably slightly lift the point of your chin to give it more shape.  Genioplasty is a straight-forward operation when it is just the chin point that has to change and not the way the teeth fit together.  I generally do not recommend chin implants.

Daniel Barrett, MD · Answer

Dear liibbby,
it is hard to tell for sure without an examination. Based on your photos,it looks like you would benefit from rhinoplasty and chin augmentation or sliding genioplasty. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Barry L. Eppley, MD, DMD · Answer

If you have no concerns about your bite relationship then the combination rhinoplasty and sliding genioplasty would be the best treatment. Your nose and chin are equal contributors in what you don't like about your profile with the nose hump being big and your chin projection too small. You are correct in that treating just one of them will still leave your profile with a less than satisfactory outcome.

Victor Manuel Agudelo, MD · Answer

Hello. In your case a rhinoplasty focused on hump removal can be performed, keeping your tip's same size and shape, so front view changes will be minimal. You will greatly benefit from a chin augmentation.  If your overbite is not a big concern and if it isn't causing oral  health issues, a chin implant will be a simple cost effective solution.

What can I do to improve my side profile? (Photo)

Answers (6)

More Rhinoplasty Questions

Will moving the upper jaw only downward affect the nose in jaw surgery?

What are the risks of getting a nose osteotomy for an Asian?

Excess skin on top of nose makes epicanthal fold. How can I get rid of it? (Photo)

What makes my nose so noticeably different from the left/right profiles? (Photo)

My nose has a very straight bridge and is quite fat at the end. Could I get a button nose with surgery? (Photo)

Will I get keloid if I get rhinoplasty? (photos)

WE SEND PRETTY
EMAILS