How much could a rhinoplasty help improve my nose. I am worried as I have thicker skin? (Photos)

To start with, I'd not flag you as thick skinned, medium and sebaceus in the worst case; I'll have you know the thicker the skin then surgeons and patients need to be aware that:
-the thicker the less likely irregularities a visible, there'd be grafting transparencies and small technical imperfection would be perceived
-the thicker the skin it is also less visible any technical gesture, that has to be over-calculated or over-corrected so that it's desired outer effect is seen

So, it is pretty favorable having a somehow oily skin and medium-thickness at the nose.

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).

Apart from all the above, your tips needs re-definition, has to be perkier and needs Sheen-type grafting.

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.

Based on your photos, you appear to have an overprojected nasal appearance seen on your profile. That means that your nose sticks out a bit too far in the bridge and tip. If you have significant dissatisfaction with the appearance of your nose, rhinoplasty surgery may be considered for achieving a less projected, less distracting, and more feminine nasal appearance. It's always best to visit one or two rhinoplasty specialists who can offer computer Imaging, so you could see what might be best for you moving forward. I hope this helps! Sincerely, Dr Joseph

Based on your photos, you are a great candidate for rhinoplasty. The larger nose can be reduced in size, both the bridge and the tip so it looks smaller on your face. Realistic expectations are important as your nose can't be made really small, but the size/width can certainly be reduced. Be sure to see a rhinoplasty expert for consultation.

At least from these photos, your skin doesn't seem all that thick to me. Looks like it's the size and shape and strength of your tip cartilages that is causing most of what might bother you about the nose. I would like to see the tip deprojected, which means moving the tip back closer to your face, and elevating the tip, and probably narrowing it some as well, and then lowering the position of the bridge to match the new position of the tip.
How *much* to elevate the tip, or deproject the nose, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that 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. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery.

Thank you for your question. You are an excellent candidate for rhinoplasty, I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

A rhinoplasty will make a marked improvement. Your nose is too prominent, it needs to be shortened and the nasal columella angle needs to be increased to 110 degrees. Your skin may be thick and is hard to tell from photographs but that should not be a problem.

Best Wishes,

Gary Horndeski, M.D.

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. Fascial grafts may also be used to help improve tip refinement. 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 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