Will just having bulbous tip slimmed leave me with a hook nose? (Photos)

Is there a reason you want to avoid working on the bone? Working on the tip and the columella is a thousand times more difficult and time-consuming than "working on the bone." In an operation that would take me about 3 and a half hours, the boney work would take less than three minutes, and it wouldn't result in any more swelling, or bleeding, or bruising. The hard part is the tip.

You have a strongly-projecting nose, which means it comes out forward away from your face. When the tip is brought back closer to the face, it tends to make the nose *look* longer, as if the tip had actually dropped, so it's very important in a nose like yours to elevate the tip. Then, the bridge would be lowered to match the new position of the tip. And as you noticed, there would be work to try to decrease the prominence of the columellar show.

But if you're considering a rhinoplasty, have *everything* worked on, or nothing. Otherwise, you'd probably just get in trouble with it.

How *much* to elevate the tip, or deproject the nose, or lower the bridge, 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.

You can certainly just work on the tip to lift and narrow it without getting a hooked nose if the rhinoplasty is properly performed. However, your overall result would be even better by working on the bridge some so that it could match your newly refined tip. The bridge would be easy work in reality. Be sure to see a rhinoplasty expert for consultation and computer imaging to give you an idea of how it would look with both procedures.

Based off your photos, you potentially can have only tip work done without doing any dorsal bridge or bone work. One thing to keep in mind is once the tip is reduced with cephalic trim and some tip work, you will likely see your dorsal hump and bridge become more significant. By doing dorsal preservation and reducing your dorsum that will also help deproject your tip and not have a long looking nose also.

Rhinoplasty surgery certainly may be considered for lifting and narrowing a bulbous and droopy nasal tip appearance. Since you appear to have a sizable dorsal hump, I don't see any negative of addressing that at the time of surgery. The goals of surgery are to provide a less distracting, better breathing, and more feminine nasal appearance that blends in. Thank you for this question, and I hope it helps! Sincerely, Dr Joseph

Success in rhinoplasty depends just as much on the balance between all parts of the nose as it does on refining any single feature. Based on your photos, the bump along your nasal bridge and the overall projection of your nose would likely become more noticeable if only the tip is refined. For the most natural and harmonious result, you’d be better off either leaving things as they are or considering a more comprehensive approach that addresses the entire nose.

— Dr. B

Your nasal columella angle is less than 90 degrees, which creates a hook like appearance. You will need a rhinoplasty to correct that, just doing the columella and tip will not be adequate.

Best Wishes,

Gary Horndeski, M.D.

Hello and thank you for your question. Based on your photographs, 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