I have considered rhinoplasty for years, but I'm worried about getting a "pinched-look." Would I be a good candidate? (photo)

Greetings, I have considered rhinoplasty for years, but I'm worried about getting a "pinched-look". My nose is triangly, large, undefined. I placed together images (i didn't take a side picture, unfortunately). I would love any honest feedback. Ultimately, I would like to have a slightly narrower, even and defined nose. The top right image is a manipulated photo of what I would be happy with and possibly a slightly more defined tip. Thank you for taking the time to look over my question. :)

Doctor Answers 13

Rhinoplasty cost

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You are an excellent candidate for a rhinoplasty. The width of the nose can be narrowed, decrease the size of the bone base and the tip can be refined. This can be done without over reduction and the operated look. The cost is approximately $7,000 in Houston.

Best Wishes,

Gary Horndeski, M.D.


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From your photos, it appears that you have a deviated nose, with a bulbous tip. Refinement of the tip can be done by reshaping the structure of the cartilage. Avoiding cartilage removal will prevent you from getting the pinched look you are afraid of. 

Seek an experienced rhinoplasty surgeon.

You Are An Excellent Candidate For Rhinoplasty

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Dear Nosebane;

Do not be reluctant to have a rhinoplasty if it is something you want.The odds that you will be happy are with you. Rhinoplasty is an immensely popular procedure because, for most people, the results are so satisfying.It works and worked for me.I had a nose job some years ago!

If you are not having the surgery because you are worried about a "pinched look," you are not alone.Unfortunately, the pinched look is when too much cartilage has been removed, and that is a tell-tale sign of an overdone rhinoplasty.The key is to pick a surgeon who who does not overdo and delivers a natural looking nose. As a matter of fact, just under doing it is better than overdoing.

I suggest doing a lot of homework.Read books, visit websites.I am proud to say my two books listed below have been very popular and will be of immense help to you.Likewise, visit my and other comprehensive websites.You are in a large metropolitan area and should be able to find a surgeon whose practice is mostly nasal surgery.That is really what you want.You want a super-specialist in rhinoplasty.That diminishes the chances of disappointment.

Defining the tip is generally done by sculpting the cartilage of the alar lower lateral cartilages.They are both horseshoe-shaped cartilages and generally symmetrical,so just trimming a portion of them can make a big difference.It is also helpful sometimes to trim the cartilage that sits just above what is called the upper lateral cartilages.In any event, if your cartilages and nose skin are deemed appropriate -- which will be determined at consultation -- your surgeon should be able to deliver credible result.

Just to give you some comfort, understand that even in the best of hands, sometimes there can be some minor imperfections.If there is an area in your nose that is a little too narrow or a little too thin, then you might consider the injection revision rhinoplasty whereby instead of surgery, injection of a long-lasting filler material just under the skin of the nose will correct the problem.

Check it out on my website as well as others.You will learn a lot.

Best wishes,

Robert Kotler, MD, FACS
Over 4,000 nasal procedures performed

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

Rhinoplasty candidate

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To narrow the  nasal bones, medial and lateral osteotomies  will need to be performed. Narrowing the tip is accomplished  with a combination of either suture techniques or cartilage removal. Any dorsal hump can be shaved down to make the nose is more balanced. Virtual rhinoplasty software is available on the link below along with our rhinoplasty photo gallery to give you an idea what can be accomplished with the procedure

Candidate for rhinoplasty?

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The areas that concern you can be realistically improved and make your nose more harmonious with your other pretty facial features by having a natural appearing rhinoplasty performed by an artistic plastic surgeon who is experienced in nasal surgery.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medicalhistory and discussing the pros and cons of the operative procedure would not be in your best surgery. Natural appearing results need to be individualized and what
is appropriate for one patient is not necessarily the best for someone else. I would  American Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (otolaryngologist) that you trust and arecomfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, M.D., FACS

La Jolla, California

Am I a Good Candidate for Rhinoplasty?

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The most difficult problem for a patient considering a rhinoplasty is selecting an experienced surgeon who will give you a natural result. Your goals are realistic and will be achieved without the risk of a "pinched result" if you follow this advice.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Considering Rhinoplasty

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One of the most common rhinoplasty requests is a narrower, more refined tip. This can be done safely by an experienced surgeon without sacrificing function or a "natural look." Find a board certified facial plastic surgeon who can demonstrate many successful results.

Roy A. David, MD
San Diego Facial Plastic Surgeon

Would I be a good candidate for rhinoplasty?

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The tip can be refined to produce a natural result through a closed rhinoplasty approach.  The alar base can be reduced as well.

Find a board certified plastic surgeon who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD

Los Angeles, CA

Good Candidate for Rhinoplasty Refinement

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Dear Nosebane,
Yes you are an excellent candidate for rhinoplasty surgery. While the imaging you included is a fair representation of some of your desires for your nose a professional imaging would be best done during consultation. Your nasal tip could use further refinement and straightening of your dorsum as well. During consultation you will have a side view and frontal view image which will show you the proposed result. This will further help you envision how your nose will look and make sure that you and your surgeon are on the same page. It is important when reviewing your surgeons before and after photographs and his digital imaging photographs that you see that they are very close in proximity. Wishing you all the best and a Happy New Year! Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 214 reviews

Rhinoplasty is a good option

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First of all, I commend you on your honest computer representation!  Yes, your tip could be reasonably narrowed without a pinched appearance.  The key is that your surgeon is well-versed in rhinoplasty, such that not too much is done to the cartilages in the tip so that there is limited impact on the surrounding structures.  The pinched appearance result when the surgeon is over-zealous in narrowing the cartilages, and the nostril margins (the alar rim) is retracted and narrowed.  These issues are easily preventable, however.

John Frodel, MD
Atlanta Facial Plastic Surgeon

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.