Will my Rhinoplasty be a difficult one ? (photos)

I would like to have a little nose correction the perfect nose to me is a small pointy nose , my nose is straight but maybe a little to long and when I smile big I can see my nose is pointing down slightly , my question is that if I decide to go with the surgery will it be a very complicated one with breaking the bone in order to get that perfect pointy nose

Doctor Answers 11

Rhinoplasty candidate

Rhinoplasty is one of the most difficult procedures to perform in the entire field of cosmetic surgery, so it's important to choose your surgeon very wisely based on extensive experience. It's also important to have realistic expectations and specific goals in mind on exactly what you're trying to accomplish. A full set of facial photographs are required to make a determination about what may be needed, since the nose is a three-dimensional structure. Breaking the nasal bones is required when a hump has been removed from the dorsum. To prevent the tip from drooping when smiling requires releasing of the  Depressor Septi ligament. For more information and many before and after examples of rhinoplasty, please see the link and the video below

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Difficult? Yes, but it certainly is possible.

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

I elevated the tip of your nose significantly, and lowered the bump along the bridge, and also tried to simulate narrowing the tip. I'm curious what you think of the amount of tip elevation that I simulated. It's kind of a short nose, but not too short, and it's "small and pointy." Of course, the patient gets to dictate what the goals of the operation are.

You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Particularly the work on the tip of the nose that is required to create these results is complicated. 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.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 41 reviews

Steps for rhinoplasty

The truth is that you need to be seen in person to get a complete, educated opinion on your nose.  It is possible that some patients just need a tip rhinoplasty to add refinement and elegance, or that others may have a gentle bridge reduction to soften the height and give the illusion of the tip turning up.  However it seems from your comments that you might be interested in both areas addressed.  That typically is still very straightforward, and components of most rhinoplasty.   In that sense, for a rhinoplasty surgeon, that would be a normal request.  If you do feel like the bridge is wide, or needs to be reduced to soften your profile, then you would likely need osteotomies to break and refine those structures.

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 14 reviews

Close rhinoplasty, some advices:

Thank you very much for sharing your concerns with us.

The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.

In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.

Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 270 reviews

Subtle Changes with Rhinoplasty Surgery

Rhinoplasty surgery is one of the most challenging cosmetic operations we perform; achieving natural results after subtle changes can be even more difficult. It is impossible to recommend specific techniques after seeing just one picture; I recommend you send a full set of pictures for nasal evaluation as described on my website.Ultimately you need to consult with an experienced rhinoplasty specialist.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Rhinoplasty surgery may be considered for achieving a smaller, less distracting, and more feminine nasal appearance.

Rhinoplasty surgery is one of the most difficult and unforgiving plastic surgical procedures, so your choice of surgeons is one of the most important decisions you may need to make. If your surgeon performs rhinoplasty regularly, an open dialogue and computer imaging during your consultation may be helpful. Consider checking credentials, photos, and reviews here on RS, and schedule a few consultations so you could see what might be best for you. Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 421 reviews


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. Cartilage grafts may also be used to help improve tip refinement. You may also benefit from a cephalic rotation of your tip to turn up your tip slightly and a conservative dorsal hump reduction.  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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

Will my Rhinoplasty be a difficult one ?

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


Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Rhinoplasty level of difficulty

Thanks for your question and picture.  From the view of your photograph, it does not appear that you have any major nasal deformities, but a face-to-face examination and full set of standardized photographs would be required to make any specific recommendations.

You asked about a few specific aspects of your nose.  Specifically will the nasal bones need fractured?  The answer to that depends highly on if you want to narrow the width of the upper part of the nose, and if there is any dorsal hump that needs to be reduced.  Regarding the "long" and "pointing down" nose, these measures are addressed through tip techniques.  

Regardless of what techniques are employed, no rhinoplasty is simple, and they all require a fair amount of recovery.  I recommend you consult with a few well regarded board certified Facial Plastic Surgeons, or  board certified general plastic surgeons who perform rhinoplasty often.

Best wishes

Daniel J. Givens, MD
Dubuque Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

All rhinoplasties can be difficult!

Thanks for the photo and the great question! The tip of your nose is composed of cartilage and not bone. There are a few reasons that patients need to have their bones broken during rhinoplasty. The most common are to narrow the width of the nose or to correct asymmetries of the nose. If you want to have a small and pointy nose, then in my opinion I would look at pre and post-op photos of various surgeons in Chicago to see what their noses look like. All rhinoplasties can be difficult, a lot depends on the patients anatomy and what types of results they want. I hope this helps and best of luck to you!

~Dr. Sieber

David A. Sieber, MD
Bay Area General Surgeon
5.0 out of 5 stars 34 reviews

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.