Hate my side profile! What can be done to my nose? I heard before that I have too much skin to get good results? (Photo)

Question

I hate my side perfil - I don’t mind the front at much as I do the side- however I have i bulbous cartilage popping on the front side . I went to a local plastic surgeon and was told I had too much skin as changes will not be noticeable. What are your opinion ?

Steven M. Denenberg, MD · Answer

Click on the "Learn more" link, just below my response, or go here:
FacialSurgery.com/RealSelf/RealSelf_ir69558.html
I made a computer morph of your nose, and an animation of the morph, to show the changes that could be possible for your nose in truly expert hands.You didn't say *exactly* what it is about your profile that you hate, so I took some educated guesses. I lowered the bump on the bridge, and I elevated the tip, and I brought the entire nose back closer to your face.At the same time, the tip could be narrowed. The woman in the short video that I posted with this answer had the tip of her nose narrowed in a rhinoplasty.It's true that thick skin can put a limit on how much change is possible, but with strong cartilages, a meaningful amount of change can often be accomplished. It's really necessary to see the nose in person, though, in order to get a "feel" for the skin's thickness and how it might affect surgery's outcome.
See if you think the morph captured what you're looking for.
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 "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon. 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. Read that page very carefully. Most plastic surgeons are quite poor at this operation, and I believe my advice will go a long way toward keeping you safe. For most noses, it's better to not have surgery than to have inexpertly-performed surgery.
I'd love to hear what you think of the morph. Did it seem to address your main concerns? I could modify the morph to your taste if you wish.
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 an attractive nose, and whether he shares your opinion of what constitutes an attractive 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. How would you ever get that figured out without the morphs?! 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.
In your case in particular, you need to find a surgeon who understands all of the issues I mentioned, and how they fit together, and who can actually accomplish them in surgery.

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 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. FACS
Harvard-trained plastic surgeon

Umang Mehta, MD · Answer

Thanks for the question and photos. You do seem to have thicker skin on your nose, which is an important feature to consider. The skin thickness can limit the degree of refinement of the tip of the nose. In other words, thinner skinned patients generally end up with a more refined and narrow tip than thick skinned patients. That said, there are still several improvements which could be made. Your bridge could be lowered, making the nose appear more feminine and soft. The tip cartilages (lower lateral cartilages) could be made thinner and sharper as well. This is done by shaving the cartilage conservatively and using sutures to change their shape. The skin and soft tissue of the nose can also be conservatively thinned, while the nostril flaring could also be reduced. After surgery, taping the nose at night and performing steroid injections can help the final result as well.  A common problem I see when performing revision rhinoplasty in thicker skinned patients is that the first surgeon removed too much cartilage from the tip, making the tip lose shape and look like a blob. I'd suggest consultations with two or three rhinoplasty specialists, and ask to see noses similar to yours. Computer morphing of your nose during the consultation can help you and your surgeon communicate the aesthetic goals.  Best regards,Dr. Mehta

Robert Singer, MD · Answer

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

Jonathan Kulbersh, MD · Answer

Your nose could be improved with rhinoplasty, which would give permanent improvements in symmetry, shape and tip. You can bring the pictures that you think would be flattering to your face and these can be discussed. When you meet with a facial plastic surgeon, he or she will consider your nose in balance with your other features and can over the cost of the procedure. I hope this helps.

Hate my side profile! What can be done to my nose? I heard before that I have too much skin to get good results? (Photo)

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Hate my side profile! What can be done to my nose? I heard before that I have too much skin to get good results? (Photo)

Answers (10)

Answer: Hate my side profile! What can be done to my nose?

Answer: Hate my side profile! What can be done to my nose?

Answer: Hate side profile? Rhinoplasty Candidate

Answer: Hate side profile? Rhinoplasty Candidate

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.