Slimmer nose, fix small upper lip and heavily hooded eyes - what procedure do you recommend? (Photos)

Based on the photos you provided, I would recommend preservation rhinoplasty and tip plasty to refine the tip and make it slimmer. This would reduce projection of the tip and give a more defined and elegant look. I don’t see a concern about the hooded eyes and would not recommend anything for the eyes. Regarding the upper lip, I do see that it looks longer. It is a normal, good-looking lip. It should be close to 13 millimeters in the middle. You could benefit from a classic lip lift under the nose, and also a corner lip lift.

Let's break it down into its three parts.

Rhinoplasty:
Yours is a tricky nose for an unexperienced surgeon; itself looks balanced within its own nasal structures, however is oversized for your face; it is a perfect triangular profile but... too large for you. This leads to the concept of "hidden hump", because indeed you have a hump and not a tiny one, however it is masked or "sunken" by the length and volume of your nasal tip. Once the work is done on the tip, which is the main issue on your nose (deproject, reduce, reshape and redefine the tip) a little "surprise" may shock the surgeon if not preoperatively thought and planned, obviously also discussed and disclosed to the patient: the dorsum has to be touched, necessarily, to rebuild another perfect triangle in good tip/dorsum balance but... smaller, hence the need to reduce the tip and the nasal pyramid in parallel proportions. Another tricky point is going to be your alar flare, now slightly large but still acceptable, however once the tip has been deprojected they'll flare further out (make a test at the mirror: pus inwards your tip and look at the alar flare), so very recommendably an alar base reduction will be indicated at the end of the procedure, another "surprise" for an unexperienced surgeon. Additionally, the alar rim support is going to be compromised and show "kinks" or notches in it due to the deprojection, which will need treatment with rim graftings (there are several types, like articulated, batten, tutors, caudal extension, repositioning of cruras, etc). With all that said, you need a very good surgeon with very good clinical understanding of the underlying challenges sometimes lurking underneath an apparently not very difficult rhinoplasty.

Upper lip: you are right the upper one might benefit from enlarging, and it is also true your philtrum is overly long (distance between nasal base and upper lip), so you can kill two birds with the stone of a indirect lip lift (aka bullhorn lift), however... this leave very visible scars and is not anything I'd recommend unless you have solid and well thought acceptance of those scars. An alternative I may suggest is performing an autologous lip augmentation with collagen from your body taken from your own dermis, safe and life lasting, no granulomas, no rejections, best option, I advise you against synthetic fillers, they are all a mess in the short or mid term. Nevertheless, from a purely technical point of view you'd be an ideal candidate for the bullhorn lip lift-philtrum shortening, once the concerns about visible scars are well thought about on your side.

-Hooded eyes: correct and on spot, but this is not attributable to the eyelids or to skin excess, you have droopy forehead and eyebrows at a young age, probably this is a feature or other females in your family, making you a perfect candidate for a supraperiosteal short-temporal-incisions forehead and eyebrows lift, an excellent choice, highly rewarding and long lasting.

Hope this helped, yours is a very interesting case for a veteran, experienced and talented plastic surgeon with devotion to facial surgery.

I recommend an eccentric lip lift. This does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This takes 1 hour to perform under local anesthesia and costs $4,000. You could benefit from a rhinoplasty to refine the tip and increase the nasal columella angle. The rhinoplasty takes 2 hours to perform under general anesthesia and costs $8,000. Both can be done at the same time if desired.

Best Wishes,

Gary Horndeski, M.D.

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. With good surgical technique, you could have an outstanding result. I never recommend a lip lift at the same time as rhinoplasty. Upper blepharoplasty can safely be done at the same time, but you don’t appear to need one. 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

Based on your photos, you appear to have relatively thin skin, with a bulbous and over-projected tip. That means that your tip sticks out a bit too far. That said, you overall appear to have a pleasing nasal appearance. Rhinoplasty surgery should only be considered in those patients that have severe dissatisfaction with their nasal appearances for many years, since it is impossible to undo, if results do not live up to somebody's expectations. You're upper eyelids appear normal, and it is difficult to evaluate your lips only on profile. I hope this helps! Sincerely, Dr Joseph

Hello! Thank you for your question. Based on your concerns, there are several ways to enhance your nose, lips, and eyes while maintaining a natural, balanced look.
For your nose, since you’re interested in a slimmer tip and more definition at the lower portion, an open rhinoplasty would be the best approach. Open rhinoplasty provides direct visualization of the nasal framework, allowing precise tip refinement and enhancement. This means the surgeon can carefully adjust the shape, projection, and rotation of the tip, reshape the lower lateral cartilages if needed, and create a more proportionate, elegant appearance. Open rhinoplasty is particularly helpful for detailed tip work because it allows controlled, predictable adjustments while preserving nasal function.
Regarding your upper lip, a lip lift is technically an option, but given your young age, it’s generally not recommended—especially at the same time as a rhinoplasty. Lip augmentation with filler is usually the safest and most effective way to enhance upper lip volume and shape temporarily while keeping a natural look. This would be your best option.
For your eyelids, you mentioned some concern about hooding, though it appears minimal. The procedure that addresses excess upper eyelid skin is an upper blepharoplasty, which can refresh the appearance of your eyes without dramatically changing your natural eyelid shape. An in person examination would give a better assessment of your expected outcome from this type of operation.
Because the nose, lips, and eyes all contribute to overall facial harmony, the best next step is a consultation with a experienced facial plastic surgeon. They can create a customized plan that addresses your goals safely and effectively.
I hope that answers your question. Best of luck!
Justin Buro, M.D.

Based on your nice post of photos, I recommend virtual consultation, but I agree with a full rhinoplasty for tip reduction and narrowing the nose with fractures and an upper lip lift with 1 cc of HA filler to upper lip combination. Fees for just those procedures is $12,000-$18,000. Again best of virtual concert with as for your upper eyelids I am concerned you might have thyroid issues and would need to work up or you have some laxity the upper eyelid and should see an ophthalmologist for that, therefore I would not recommend doing any upper eyelid surgery at this time until you’ve worked up the possible issues of thyroid disease or laxity of the upper eyelids. Again, best of virtual consult with.