Are Drastic Nose Jobs Possible at All?

                 Rhinoplasty results can be subtle or more dramatic. There are some limitations on final result based upon skin thickness and the necessity to breathe. Find the plastic surgeon with ELITE credentials who has performed hundreds of rhinoplasties.   Then look at the plastic surgeon's before and after photo galleries to determine who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Different people have different goals for rhinoplasty. Many don't want dramatic or drastic changes, while others what their noses really changed. Part depends on what you start with, and part depends on your anatomy; nasal cartilage strength and skin thickness. 2-D and 3-D computer imaging is a great way to demonstrate potential changes. A skilled surgeon (and imaging user) would demonstrate reasonable changes with the computer.

  Everyone has  their own definition for the word "drastic". It's important to have realistic expectations, and all of the nasal  components  balance with themselves and your new nose balances with  your facial features, and breathes well. Look for an experienced rhinoplasty surgeon who  you can  communicate your goals too, and use computer imaging to help you visualize  the result that your you and your surgeon are both satisfied with.   A Closed rhinoplasty approach can accomplish making the required changes with all the incisions placed on the inside of the nose itself. For many before-and-after examples of closed rhinoplasty, please see the link and the video below

Yes, drastic changes are possible.  You mentioned a concern that the pre and post op photos have only conservative differences.  Please realize that the rhinoplasty surgeon typically first asks the patient what they don't like about their nose and then plans a correction based on the patients desires.

There are some noses with large dorsal humps and beaked tips that do do require significant changes to fall within the normal range.  There are a variety of techniques used to create these changes including osteotomies, cartilage trimming, and cartilage reshaping using sutures.

If you are interested in a rhinoplasty then seek out a consultation with a board certified plastic surgeon.  Prepare for it by clearly deciding in your own mind what it is you want to change about your nose.  It will help to surgeon make a plan that will satisfy you.  Good luck to you.