I have large nostrils and a long nose tip. I have decided not to go with a rhinoplasty and want a minor nose surgery. (Photo)

I opted out of having a rhinoplasy . When I push down slightly on the tip, I like what I see. I told the doctor what I want but he said that it will make me look like I have a beak. It does look like a beak if I press down hard but I just want a slight change. When I pull back my columella, my tip looks rounder and fuller. Can the columella be cut and sutured? Would a general surgeon do it? I know exactly what I want, I tried to capture it with these photos. Thanks for reading this and for any advice.

Doctor Answers 3

No rhinoplasty--just "minor nose surgery."

I am concerned by a number of your statements. First, there is no such thing as a "minor" nose surgery, though I do understand that you are not asking for hump removal or breaking of your nasal bones, just tip rhinoplasty.

What I think you dislike about your nose appears to be the over-projection of your nasal tip. You described it as "long" yet when you push your nasal tip "slightly down" it actually lengthens your nose and gives you a "hanging tip" or beak-like nasal tip. I think you want your projection shortened, and that makes your dorsum humped more than it is right now, as your unadjusted profile is almost straight. Do you want a hump when you don't have one now, or do you just want your tip retruded and your nostrils less long and somewhat smaller? Unless you want the increased hump that retruding the nasal tip creates, then the dorsum must be reduced as well, and that in turn may well require osteotomies to restore the nasal pyramid properly, maintaining proper relationships among the nasal components.

Frankly, this would take some back and forth discussion, since YOU may know just what you want, but if your surgeon is not capable of reading minds, there is a high likelihood that you will not achieve your goals.

I think you have clear ideas about what bothers you about your nose, but like too many patients, try to "get by" with less surgery than may be necessary to achieve those goals. Surgeons eager to "make the deal" to proceed with surgery will listen too little, explain inadequately, and do what they think is a "fine" rhinoplasty, which may be entirely NOT what you had in mind.

My advice is to obtain one or two more ABPS-certified plastic surgeon or ABO-certified ENT surgeon consultations and see if you can get any questions cleared up, and a precise plan agreed upon. This will minimize the risk of your being back on this site complaining about "bad plastic surgery" when your goals were not met. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

The columella can be cut and sutured

This is a fairly simple procedure that can be done in the office. Any general plastic or facial plastic surgeon could do this. Your tip will still relax downward after the procedure. You also won't address any other areas of the nose with this move. Remember, what you can do with your hand and what is done after surgery has healed are not always the same thing. If you can find a good surgeon who agrees with your plan then you would have a good chance of it working. It would also be relatively easy to reduce the nostril size at the same time if still needed.

Garrett H. Bennett, MD
Manhattan Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Tip rhinoplasty versus full rhinoplasty

 A tip rhinoplasty can  only be performed for a select few individuals when the tip is out of balance with the remainder of the nose. Performing a  tip rhinoplasty when there's a dorsal hump and overly projecting tip in a wide bridge will only lead to nose  that is unbalanced and out of proportion. It is very important to have the nasal cartilages and bony components balance with each other and the entire nose must balance with your facial features

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

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