Revision Rhinoplasty - can my nose and nostrils be made smaller? (Photos)

Your nose is still very strong in its forward projection away from your face. A main goal would be to bring the nose back closer to the face, "de-projecting" the nose. The front-to-back length of the nostrils shrinks as the tip comes back closer to the face. Then the nose looks long-ish to me as well: we'd want to elevate the tip. That would be especially important, because when you de-project a nose, it tends to make the nose *look* longer yet. Also, elevating the tip would give another opportunity to make the nostrils even less conspicuous. And finally, we'd lower the bump on the bridge to match the new closer and elevated position of the tip.

How *much* to elevate the tip, or deproject the nose, or make other changes? 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 better just 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 really 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 the surgeon has that information and judgment best.)

Finally, 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 -- the de-projection, shortening, and the face that it will be a revision -- require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery.

Hello and thank you for your question. Based on your photographs, you are a great candidate for revision rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, correction of alar retraction with extended alar contour grafts, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon