I am not confident with my nose, would you recommend surgery or a non surgical nose job?

Question

I like that my tip goes down and I dislike how many operations turn the tip up. I want a subtle change and I like my frontal view. Also I'm scared of the surgery but I think my nose is too big for the non surgical procedure.

Steven M. Denenberg, MD · Answer

Click on the "Web reference" link, just below my response, or go here:

FacialSurgery.com/RealSelf/RealSelf_elisagdg.html

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, but much less than my typical patient requests. You get to decide how much tip elevation you want. I also lowered the little bump on your bridge. I'd love to hear what you think of the morph.

You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  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.

Alejandro Nogueira, MD · Answer

Non-surgical nose job does not exist, to begin with, no matter how much it is promised or promoted, it is a fraud, frustrating, dangerous, even deformating over time, a total mess without any scientific ground.Get a rhinoplasty or get nothing on your nose.Based of your pics you are a good case for a feminization rhinoplasty, with moderate to slight reduction; yours is not a massively oversized nose, neither an ugly one, but is a nose not fitting into your beautiful feminine facial features. This means that just a reduction rhinoplasty would meet your expectations, you are a case for deep structural work in order to feminize your nose, mainly at tip, supratip and lateral cruras.I'd perform complex tip plasties with grafting (Sheen's), eventually columellar strut or alternatively tongue in groove columellar fixation, plasties or grafting at lateral cruras and and overall slight reduction of tip, sorsal hump and osteotomies.Do seek the services of surgeons especialized in complex rhinoplasties, ethnic works or transgender.

Eric M. Joseph, MD · Answer

If you like that your tip goes down, it may be best to do no intervention on your nose. Fillers may make your nose appear larger. Rhinoplasty would be considered if you wanted tip rotation and narrowing, along with bump removal. Hope this helps. Dr Joseph

Richard G. Reish, MD, FACS · Answer

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. You may also benefit from 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

Stephen Prendiville, MD · Answer

It is important to understand that the term "nonsurgical Rhinoplasty" is somewhat of an overstatement.  It's somewhat like calling a bicycle a "carbon-free Ferrari"; there are some parallels but still remain very distinct entities.  This terminology refers to use of fillers in the nose, generally to raise the bridge in specific circumstances.  The photos show a dorsal hump and a somewhat bulbous tip, both of which would best be addressed with a Rhinoplasty, performed by experienced hands.

Kenneth Hughes, MD · Answer

It depends upon what you want.  The tip can be refined and the hump can be reduced.Kenneth Hughes, MDLos Angeles, CA

Jeffrey Jumaily, MD · Answer

This really depends on what you want to improve and your goals. Non surgical rhino can hide the hump a little bit and it won't make your nose much bigger. If you want more refinement to the tip etc then surgery is the best treatment. Go in for a consultation and discuss with a rhinoplasty surgeon

Karthik Ram, MRCS, DNB · Answer

Hi thanks for your enquiry.As you desire you can undergo cephalic trim and fine tip refinement and achieve what you wanted.The final outcome should balance well with rest of your facial features.Be realistic with your expectations do your home work and get a detailed assessment from a board certified plastic surgeon and plan your procedure,Good luck.

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