Still hate my nose. Too big and too conservative. What can I do? (Photo)

Question

Asked for a more feminine less sharp,smaller nose which is much less projected.A small improvement but I asked for slight slant&much closer to my face.I said go drastic! But I still can't have someone stand to side me,I am so paranoid I still have such a big nose.Op 6mth ago.What can I do as it wasn't what I asked for.I was very clear.At 3mth i asked will it come down closer to face as I asked,surgeon said a little but could not make it smaller as it wouldn't suit face?? I don't like it. Help :(

Steven J. Pearlman, MD, FACS · Answer

There is an old dictum in plastic surgery: it's easier to take off more than to take off less." Rhinoplasty is not an exact science like constructing a house. You can do the same surgical maneuvers on two different patients and get different results. I suggest you give it a full year to heal then either go back to your original surgeon or see a revision rhinoplaty expert for a consultation.

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for sharing your concerns about your Rhinoplasty with us.Congratulations for having patience and wait six months PO, which is the recommended time allowed to make judgments of value and be precise and accurate.After having analyzed all the info and photos provided to us, i recommend to perform a Secondary Rhinoplasty (not a tip revision) this means (basically) treat the nasal bones and the nasal cartilages.Therefore i would perform a narrowing of the nasal base (nose osteotomy) and alar and triangular cartilage shaping.Respectfully,Dr. Emmanuel Mallol Cotes.-

Steven M. Denenberg, MD · Answer

It's an improvement over your original nose, but I see what you're looking at. 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 could be possible for your nose in truly expert hands.
Mostly, I brought that tip back closer to your face. Even after moving the tip back quite a bit, it's still strong enough to offset your strong chin.The good news is that deprojecting a nose is one of the more predictable changes to make, even in a revision, although it is a technically demanding operation.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 revision 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'll change, and by how much he'll change them -- so you know whether it's enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. Then, he must show you before and after photos to prove that he can actually accomplish what he draws on the computer.

Tanveer Janjua, MD · Answer

The photographs show an excellent result.  Considering this is not what you wanted, you might want to talk again to your surgeon or another surgeon about reducing it in size even further.However, my recommendation would be to not undergo any further surgery as the nose complements your face and looks excellent.RegardsDr. J

Steven Wallach, MD · Answer

You have a nice results but I appreciate what you are saying. Remember as you try to shorten your nose or deproject it, you may get a flatter looking wider nose to accommodate for soft tissue collapse.

Joshua A. Halpern, MD, PA · Answer

Thank you for your question. I enjoy doing rhinoplasty's. I think it's based off the fact that I started as an art student at the Los Angeles county museum of art. I like to do what I call reshaping rhinoplasty's, this is where the surgeon reshapes the nose by reshaping the cartilage using suturing techniques, cartilage graphs and removing excess bone and cartilage to achieve the final result. I like to find out from the patient her goals. Then I examine the patient. I then write up a surgical plan and review it step by step with the patient. I pinoeered the Finesse Technique, this is a way of performing surgery where blood loss is minimal, post operative pain is minimal, and recovery is quicker verses more traditional techniques. It is not uncommon for patients to take only Tylenol for pain after surgery.For more information please see the attached video. We do offer complimentary consultations (813) 872-2696. I hope you find this information useful.

William B. Rosenblatt, MD · Answer

Wait a full y ear and if you are still  unhappy get another opinion. Usually noses can be made smaller without a problem.

Donald Nunn, MD (retired) · Answer

You need to give things a while longer before considering a revision.  Your photos show a definite improvement.   At one year post op you could consider a revision if you are still unhappy.  But keep in mind that your surgeon can only make your nose so small due to the fact that the skin has to shrink wrap around the underlying bone/cartilage structure.  Good luck.  Donald R. Nunn MD  Atlanta Plastic Surgeon

Still hate my nose. Too big and too conservative. What can I do? (Photo)

Answers (8)

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