What can be done for my 'square' nose? (photos)

Question

I hate how my nose is really square. I've attached a picture looking upwards - rather than it having a normal tip, I almost have two tips and a straight line between them, making it look very square. Is there a term for this, and what would need to be done? Is it a complicated, or especially expensive procedure? I've attached a diagram showing the shape I like. My nose is also very wide. One picture shows it front on - I would like to slim it and create a tip. Any advice much appreciated!

Alejandro Nogueira, MD · Answer

You are right, you have a square tip aka boxy tip, with a cleft in the midline and oversized; it would be interesting viewing side views to assess your profile.About the tip and your goal I can tell you that is feasible by means of:-open approach-removal of the fibrofatty pad between the domes of tip-Ortiz-Monasterio's plasty of the domes to sharpen the plateau-medial plication to make the nose triangular and get rid of the cleft-probably a slight shorteningI can't tell about the profile due to images shortfall.

Scott Trimas, MD · Answer

I think you have described your concerns quite effectively. It appears that you have divergence of your lower lateral cartilages that would normally come together to form the tip of your nose. The best way to correct that would be to narrow those cartilages by bringing them closer together either by suturing them closer together or by reducing the width around them and then bringing them closer together. It appears you have normal skin thickness which would make the procedure easier. It is not a terribly complex procedure and the results should be very close to your desired results and illustration that you submitted. If you notice in that illustration, the shape of the nose is more pyramidal which is considered more aesthetically pleasing. Good luck in your area.

Fred G. Fedok, MD, FACS · Answer

In general terms the wide nose can be corrected through a number of maneuvers.  Some of these maneuvers are a matter of repositioning structures. Other maneuvers will add structure to change the height vs the width characteristics of the nose.  Still other maneuvers will involve removing some structure --- this must be done only very judiciously or if overdone the nose will slowly shrink uncontrollably  in some areas and create long term problems like breathing issues.I advise that you seek out the advice of an experienced rhinoplasty surgeon and then only proceed after careful consideration of the options provided.  The American Academy of Facial Plastic and Reconstructive Surgery can refer you to experienced surgeons in your area.Good luck, Fred G.Fedok, MD FACS

Steven M. Denenberg, MD · Answer

... but I or any other surgeon would need more photos to see just what should be done. For example, profile view to see how much the bridge might need to be built up. And three-quarter views give much more detail about the exact shape of the tip cartilages.

Roberto E. Garcia, MD, FACS · Answer

Thank you for your question. This is very common area that is addressed during tip rhinoplasty. It appears you have whats called a boxy tip. This is a result of wide cartilages of the tip of the nose.  This can be addressed very simply with some refining techniques. Please consult a double board-certified facial plastic and reconstructive surgeon for advice.

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for sharing your concerns with us.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully,Dr. Emmanuel Mallol Cotes.-

Vincent N. Zubowicz, MD · Answer

The photograph demonstrates a tip that could be addressed by correcting the diastasis, pruning the cartilages that form the nasal tip as well as reshaping them. Video imaging would give a good idea what to expect. Make certain you see lots of pre-and postop photographs from surgeons you interview.

William A. Wallace, MD, FACS · Answer

The condition you describe is termed a "boxy tip" in rhinoplasty terms. It has to do with a wider than customary distance between the tips of the lower lateral cartilages that help define your tip and nostrils. This would best be corrected through an open rhinoplasty. A full consultation with internal and external nasal exam would best determine your needs.

William Portuese, MD · Answer

The bulbous tip is made more triangular with a combination of suture techniques and a conservative cartilage removal applied to the lower lateral cartilages of the nasal tip. For more information, diagrams and many examples, please see the link and the video below

Sean Freeman, MD · Answer

hallie345, your lower lateral cartilage needs to be worked on to change the shape of your tip. Perhaps your nostils may need a bit or work at a later date (an alar rim procedure). See a experienced surgeon who specializes in only faces. search the Internet! Good luck!

What can be done for my 'square' nose? (photos)

Answers (14)

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