Upturned nose. Male. No previous surgery. How can I make it less bulbous? (Photo)

Hello and thank you for your question and sharing  your photographs.
The combination of changes that you look to achieve is favourable.  In general,  increasing the tension in the skin makes it possible to produce more definition.  Septal extension grafts are a powerful mechanism  to help with lengthening and stabilising the tip. When the tip is de-rotated,  more of the bridge is exposed and it facilitates the perception that the  nose is slimmer viewed from the front,  this combines with the reshaping of the  nasal tip cartilages.
 The primary  source for cartilage for the septal extension graft is the septum.  However, if there is  insufficient cartilage  in the septum, or the cartilage is soft,  I tend to favour rib cartilage for this purpose,  since it provides good stability for the long term. 

Rhinoplasty requires exceptional skill on behalf of the surgeon and great communication with the patient about realistic goals and expectations.
Common cosmetic concerns include a dorsal hump, wide nose, sunken nose, irregularities, and asymmetries. Functional concerns include difficulty breathing through the nose, which can and should be addressed at the same time as your rhinoplasty.
Make sure to seek out the care of a board certified surgeon with extensive experience in rhinoplasty. Find someone you connect with, who will listen to your concerns and provide you with a framework for what is possible. A septal graft can be used to correct the rotation of your nose and tip altering maneuvers can be used to make less bulbous. Gary Linkov, MD
Rhinoplasty Specialist
Manhattan

Consider consulting with surgeons facile in the use of septal extension grafts. These are grafts of your septal cartilage that may be placed below your septum to de-rotate your nose, and achieve a longer, less upturned appearance. Nasal narrowing in your bridge and tip may be performed at the same procedure. Hope this helps. Dr Joseph

Hi and thanks for your questions and photographs. It is absolutely possible to improve the appearance of your nose with a surgical rhinoplasty. This procedure can be designed to refine the nasal tip and reduce the bulbosity. At the same time the nose can be de-rotated so that the nose does not look so up-turned. This would likely require a cartilage graft known as a caudal septal extension graft which helps elongate the lower part of your septum and gives a stable point to anchor the nasal tip so that it stays in the lowered position permanently. Because you haven't had prior nasal surgery, the cartilage for this graft can be removed from your nasal septum. I'd suggest in person consultation with a facial plastic surgeon experienced in nasal surgery who can perform a comprehensive physical examination and further assess your candidacy. 

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty which can be performed by trimming, suturing, and reshaping the cartilage in your lower nose. You may also benefit from a nasal tip derotation and septal extension graft.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Thank you for your question and sharing your photographs.
Your goals are achievable by using septal extension graft to reduce over-rotated nose and nasal tip refinement by cephalic reduction and inter- and transdomal suturing to resolve bulbous nature of your nasal tip.
Please make sure to seek out the care of an experienced nasal and rhinoplasty surgeon who can deal with your cosmetic concerns without compromising nasal airway.
Best Wishes

Hi and welcome to our forum!From your photos, I note a high nasal bridge, a broad nasal base, a rounded amorphous tip and a shortened nose with an increased angle from nasal tip to upper lip.These features can be corrected with a rhinoplasty to narrow the base, lower the bridge, and add definition to the tip as well as lengthening with septal extension grafting, decreasing the nasolabial angle.. Visit a board certified plastic surgeon for in-person evaluation and discussion.Best wishes...