I like the size of my nose, just not the tip and front droop. My nostrils look like you can see the inside. How do I reshape it?

Rhinoplasty / tip of nose. I like the size of my nose, just not the tip and how it is hook like I am not sure of the correct term of what it is called bulbous tip? Anyways how and more importantly what (DOTOR) is best to fix or recreate the shape without having remorse? Or am I better off leaving it alone ? Thank you in advance

Doctor Answers 10

I like the size of my nose, just not the tip and front droop. My nostrils look like you can see the inside. How do I reshape it?

  If your tip is not wide from frontal view, I would not offer a rhinoplasty for you.  Your nose looks good.

Kenneth Hughes, MD

Los Angeles, CA

Tip plasty candidate

 There are of small percentage of patients who were able to undergo just a tip plasty only, when the rest of the nose is in excellent balance. The bulbous tip is addressed with suture techniques and sometimes a cartilage removal from the lower lateral cartilages of the nasal tip. The columellar show can also be reduced to make the nose looked less bottom heavy and reduce the slight downturn of the nose. Most patients must undergo full rhinoplasty not a tip rhinoplasty to make sure the entire nose is well-balanced. 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Nose surgery

Improving the nose is the most challenging and specialized operation that Plastic Surgeons perform. In my opinion, isolated tip plasty is rare. when you change one aspect of the nose --- other areas become more obvious. Although, you may think that only your tip will need improvement-- it most likely will require slight additional improvements as well. I would seek a Qualified Board Certified Plastic Surgeon who is able to demonstrate a variety of Before and After photos.

I like the size of my nose, just not the tip and front droop. My nostrils look like you can see the inside. How do I reshape

Over the internet advise are just us giving you educated guesses.. At first I thought a tip rhinoplasty but again I think now a full rhinoplasty would offer a better outcome. So best to seek IN PERSON opinions ONLY! 

Rhinoplasty droopy tip

One of the things I love about Realself is the detective work sometimes required of us poor surgeons to sort out the issues posed by the community. Your question is a really good one - but the image you post shows us only a glimpse of your nose, from one view, and it's in a car!

I think you can be figured out.  

From the side view, we see a little too much columella.  This can be due to either alar retraction, or a hanging columella.  From the view you post, I can't tell which it is.  But the effect is the same - you see "into" your nose from both the side and front views. Ideally, the alar rim from the side view should be only slightly higher than the columella, so that on the front view the curve across the bottom of the nose from side to side should be a gentle "gull wing in flight", not too steeply angled. Either recessing the columella or lowering the alar rim will improve this, and a careful exam by an experienced rhinoplasty surgeon in your area will let you know which is the best strategy in your case.

The other clue we have is the slight bump visible in your nose about 1.3cm or half an inch above the tip. This is the lower end of the septum, and it is a fixed point. When you smile, the lip depressor muscles tend to pull your tip down and deproject it.  This is called a "tension nose".  In your case it will make your nose more beak like, or hooked, when you smile.  And people smile in photos, so they notice it. When you're in repose it's not really there.

Tension nose can be fixed in one of two ways, and which one depends upon the degree of septal and tip projection. A minimal dorsal reduction will work, and the other technique which works is to fix the relationship between the lower septum and the tip, usually by using a septal extension graft, as well as defunctioning the lip depressors.

It's possible to do all of this without fundamentally changing the shape of your nose.

My advice is that if it really bothers you, it can be fixed, but choose experienced rhinoplasty surgeons in your area for consultations and learn about your options and risks properly.

All the best.

Howard Webster 

Tip

Thank you for the photos and questions - clearly one needs to do an examination and take digital photos and then alter them with your input till you see the changes to your nose you are looking for.  Then ask your surgeon how he can accomplish it.

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 60 reviews

Limited tip rhinoplasty

From the photographs you submitted, it does appear that you have somewhat of a bulbous tip with tip ptosis or a drooping tip. It is often possible to correct just the tip unit if the remaining portion of the nose especially the middle third and dorsum (upper third) are in good position. That being said sometime some additional work may need to be done to bring the nose in harmony or balance. I would seek a facial plastic surgeon or plastic surgeon who does a lot of rhinoplasty procedures. The tip of the nose is often the most difficult to do correctly and has the highest revision rate so it is appropriate to ask your surgeon if he/she is comfortable with revision rhinoplasties as  well.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Don't like my tip

Without getting technical I would see a board certified plastic or facial plastic surgeon who does a lot of cosmetic rhinoplasty work. As long as you do not have breathing issues it should be very straightforward. However, you need to ask to see examples if their work and also talk to a patient of theirs with a situation similar to yours. Reviews are now worthless in most cases as many surgeons generate their own and everybody looks great. Websites are also worthless and the most glitzy can be from a new graduate who has done very few of anything. Don't believe the hype on the websites everybody has it. The best way is still word of mouth and actually seeing their results and talking to other patients. Also take a look at their training to be sure they are well trained and certified. 

Grady B. Core, MD
Birmingham Plastic Surgeon
4.5 out of 5 stars 11 reviews

Rhinoplasty?

If your tip does not look wide from the front, then based solely on the side view I would not touch your nose. If the tip is wide, then a tip plasty can help. 

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Alar retraction

You appear to have slight alar retraction that may be fixed with a graft.  The side photos do not show if you have a bulbous tip that need correction.  I also did not get the impression that you have a droopy tip.  This may be more evident when smiling.  I would recommend a nasal analysis with a plastic surgeon to see if a tip rhinoplasty is warranted.  Best wishes!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.