Rhinoplasty? Alarplasty? What do I need? (Photo)

Question

I want to get a consultation for my nose, but I’d like to know what questions to ask. I really hate my side profile. My nostrils are so long and almost look arched. My nose is also crooked which I think makes it look even bigger from one side. Also I think it would look better if the Tip was lifted. I’ve always been insecure about it and I’m finally ready to get it resolved. Any input would be very helpful! Thank you!

Jonathan Kulbersh, MD · Answer

Hello, and thank you for providing photos along with your question. Based on these photos, you may be a candidate for both a rhinoplasty and a septoplasty. You seem to have an overprojected nose, plus the crooked appearance may be due to a deviated septum. The two procedures can address your nose projection and nasal asymmetry.

To determine the best approach, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon, particularly one with a strong rhinoplasty portfolio. Such experts will have the training and experience to perform the most advanced surgical techniques, as well as artistry and knowledge of facial aesthetics, harmony, and proportion, helping you achieve the most natural-looking results. During your consultation, your surgeon can assess your facial profile, recommend the best approach, and ensure the best possible outcome.

Zoran Potparic, MD · Answer

Based on these photos, you are excellent candidate for septo-rhinoplasty. Beside reducing the hump, you will need correction of the nose tip and nostrils, possibly airway improvement. Significant amount of cartilage grafts will be needed for this purpose; they are usually harvested from patient's septum. In person consultation with an experienced, board certified plastic surgeon, expert in rhinoplasty, is recommended. Good luck.

Ajaya Kashyap, MD · Answer

Thankyou for your question. Based on your pictures you will benefit from both correction of the asymmetry and lifting of the tip. This would mean getting a full rhinoplasty with possibly a septoplasty. Please find an experienced Board certified Rhinoplasty surgeon near you and prepare your questions with all your concerns  in advance before the consultation. 
The usual consultation starts with  a detailed history and  physical examination followed by photography, 2D and 3D. After a detailed analysis of your nose, your expectations are discussed, and a morphing of the possible results is done with your pictures. You can discuss all your concerns, risks, benefits and expected results at this time. You should also discuss your surgeon’s experience with rhinoplasties and his techniques as well as pre and  postoperative care. A CT scan or other imaging studies/ endoscopy may also be recommended. You should also talk to some other patients who have gone through the procedure. 
  All the best!

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. You are an excellent candidate for rhinoplasty. I think rhinoplasty is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. All of the issues that you have mentioned can be corrected will a skillfully performed rhinoplasty. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Ronald J. Edelson, MD · Answer

You are an excellent candidate for rhinoplasty. There are so many different ways to do it that I recommend going on a few consults to figure out what would be your best option. Selection of the right surgeon is the most important thing

Barry M. Weintraub, MD, FACS · Answer

The most important question to ask is if the doctor is a board certified plastic surgeon. If the answer is “yes,” then ask for pictures of rhinoplasty results he or she has personally produced to determine if your aesthetics align. Safety should always be #1, so ask about the anesthesiologist who will be taking care of you. Does the surgeon work with this anesthesiologist regularly? Is the anesthesiologist board certified? If your surgery is taking place in an outpatient facility, is it licensed and accredited and inspected? Ask who you can call if you have questions or concerns immediately postoperatively. Also ask if you will be seeing the surgeon postoperatively, or will you never meet with the surgeon after your procedure. In addition, I would ask if all postoperative visits are included in the price. Ask if there is a revision policy:  if an adjustment were needed, would you be charged full price? I know my answer is a bit lengthy, but it should give you an idea of how much time surgeons should spend with patients during consultations! In my own practice, my consultations can take up to a full hour, because surgery is serious and it warrants focused time. I have specifically not discussed the anatomy of your nose in the photos because that part of the consultation is best done in person. To add one other very crucial piece of information:  make sure, even your aesthetic is aligned with your surgeon and all of your questions have been answered in a satisfactory manner, that you feel comfortable with your surgeon. I perform many revision surgeries, and the one commonality that patients share with me about their prior surgeons who left them with a subpar result is that patients “went against their gut feeling.”

Robert Ciardullo, MD · Answer

Are you a good candidate for Rhinoplasty and septoplasty? From the pictures that you show it appears that your nose is slightly long and over projecting based on standard norms of female aesthetics. It is also crooked which probably means that you have a deviated septum as well. Your other features appear to be very pretty, so if your nose bothers you a Rhinoplasty combined with septoplasty could be performed which would reduce the size, length, and projection of the nose. It would elevate the slightly “droopy“ tip and at least partially straighten the crookedness. I think most plastic surgeons would consider you a good Prospect given your otherwise very pretty face.

William Portuese, MD · Answer

The Side profile photographs demonstrate an overly projecting nose, and an under projecting chin. Consider placement of a Chin implant to augment your chin forward to help with facial balance and proportions, especially with respect to your nose from the Side profile. A closed rhinoplasty approach can accomplish shaving down the dorsal hump and reducing the projection of the nose in addition to tucking in the hanging columella. Very little tip surgery is going to be required since you do not have a bulbous tip.  An alar-plasty does not need to be performed since your nostrils are not very wide.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note that your nasal septum is displaced from midline, your nasal bridge is high and demonstrates a small hump deformity, you demonstrate a nasal tip droop.
A septo-rhinoplasty will straighten your nose, lower the nasal bridge (creating a gentle feminine curve), and elevate the nasal tip. 
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...

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