I am considering having a rhinoplasty to redefine my nose. It is wide and appears to be getting larger even with age (Photo)

. There doesn't seem to be anything wrong with the bone, howere if I look up I can tell the nostrils are a bit uneven, one is larger than the other. I am also considering eyelid surgery for my heavy lids. Any recomendations on procedures open vs closed, etc would be so helpful. Thank you!

Doctor Answers 8

Closed rhinoplasty 100%

Closed rhinoplasty 100%.  No reason at all to do open rhinoplasty for your nose.  Open rhinoplasty involves making a cut at the bottom on the nose, inflicting a scar in the middle of your face permanently.  While necessary for reconstructive or revision nose surgery, its totally unnecessary for primary cosmetic rhinoplasty. 


Uneven nostrils are common and likely not to be fixed much without significant reconstructive changes.  If you are looking for a finesse but meaningful change, i would recommend narrowing the bones (so not as wide from the front), shaving down the profile (decrease the projection or amount the nose sticks out), and sculpting the tip of your nose. 


Do seek counsel with a closed scarless rhinoplasty expert who performs closed rhinoplasty daily. 

All the best!


Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 13 reviews

Great candidate for rhinoplasty, but you have to do your homework...

You have a difficult nose to correct with predictability. Your tip is wide, and the tip should be brought back closer to your face.

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 brought the tip of your nose back closer to your face. I lowered the bridge to match the new position of the tip. I tried to simulate narrowing the tip, too. And I raised the tip up a bit as well. When the tip of the nose comes back closer to the face, it can make the nose *look* longer, so elevating the tip is a good thing to do in that situation.

Bringing the tip back, lowering the bridge, and elevating the tip all participate in making the nose look less prominent.

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.

Eyelid surgery is commonly done at the same time as a rhinoplasty. For the nose, don't worry about open or closed; rather, find the surgeon who gets the results that you want, and then have him use whatever techniques allow him to get those results.

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 37 reviews

Closed rhinoplasty and eyelid surgery

A closed rhinoplasty procedure can accomplish narrowing and refining the bulbous nasal tip, shaving down the dorsal hump, reducing the projection of the nose and narrowing the bridge line, with all of the incisions placed on the inside of the nose. An upper blepharoplasty procedure can accomplish reducing the excess hooded skin on the upper eyelids. For more information and many before-and-after examples of  both procedures, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Nose

Cricketz50, You are a candidate for rhinoplasty and you may in addition need alar rim surgery. Just make sure you see an experienced facial specialist with good photos; make sure they do "only faces". For your upper lids I would most likely be addressing your brows/forehead but an exam would be needed to accurately assess this area. Again see an experienced specialist. Take a look at the video and good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.8 out of 5 stars 45 reviews

Rhinoplasty

Thank you for your question. I think a rhinoplasty to shorten your nose slightly and refine the tip will look good. It can be done at the same time as your eyelids. Open vs closed is the surgeon preference and you can get good results with either. Good luck

Jeffrey Jumaily, MD
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

I am considering having a rhinoplasty to redefine my nose. It is wide and appears to be getting larger even with age

Hello Cricketz50 - Thanks for your question. A rhinoplasty procedure is often a good option for patients wanting to decrease the size of their noses. Both open and closed rhinoplasty procedures can be performed, but this is usually just a preference of the surgeon. Nostril asymmetry can be addressed at the time of surgery, but some asymmetry in the nose is going to be normal. Looking at your pictures, it seems as if you have an overprojected nose and large tip cartilages. A properly performed rhinoplasty can improve both these issues making your nose blend better into your other facial features. I would recommend that you consult with a rhinoplasty specialist for an in-person exam, photos, and simulations. I would be happy to speak more about this with you at my Denver office. 

Have a great day! 

Dr. Shah 

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 47 reviews

Considering having a rhinoplasty to redefine my nose. It is wide and appears to be getting larger even with age

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.

Eyelid surgery can be performed at the same time as the rhinoplasty.

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

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 nasal tip deprojection to decrease the overall size of your nose 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 77 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.