I want my nose tip to be feminine and petite and not turn down into this massive arrow when I smile. What can I do? (Photos)

Question

I am 38 Female. I had a rhinoplasty in 2019, however the tip was left quite bulbous, which is extremely visible when I smile. And I smile all the time. I want my nose to be smaller and feminine and not be the focal point of my face. What exactly do I need done? And who specializes in this? I want a small feminine nose!

Eric M. Joseph, MD · Answer

Based on your photos, we can see that you have a wide nasal tip, along with nasal tip asymmetry. This may be corrected, along with droopiness with smiling. The key is to find a surgeon who has a robust and favorable before and after Gallery, along with favorable consumer reviews. Wishing you well moving forward.

Guray Yesiladali, MD, FEBOPRAS · Answer

Hello. Thanks for the details. Without an in person exam any plan is provisional. Here is a concise roadmap.
What is likely going on• Tip support is weak so the shape broadens on smile• Dome definition is soft so light spreads across the tip• Depressor septi pull can widen and drop the tip on smile• Skin thickness can mute definition
Will time fix it• Shape is stable at this stage• Meaningful refinement needs structural work
When a revision makes sense• Persistent tip bulk in neutral and on smile after month 12• Goals focused on a smaller balanced tip without overresection
What a revision usually involves• Columellar strut or septal extension to set projection and rotation• Dome sutures with limited cephalic trim or lateral crural tensioning• Address depressor septi if needed• Conservative alar base work if the base is wide• Ear or rib cartilage when septal supply is limited• Selective soft tissue thinning only
Expectations and timeline• Tip swelling for months• New baseline by month 6 with refinement to one year• Thick skin limits sharpness yet steady feminine definition is achievable
Who to see• A revision rhinoplasty specialist with strong tip cases and smiling views
Wishing you a smooth path to a smaller softer tip that feels natural at rest and on smile.Güray Yeşiladalı, MD

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty. A 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. 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

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

I want my nose tip to be feminine and petite and not turn down into this massive arrow when I smile. What can I do? (Photos)

Answers (3)

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