Nasal Tip Deprojection with Thick Skin (photo)

Question

Can most plastic surgeons perform deprojection of a longer nose with thick skin? I’ve been doing my research and haven’t found many photos that show this. Mostly just humps.Would it be better to choose a board certified facial plastic surgeon? I really love the front view of my nose but I’m not satisfied with my side profile view.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can understand from your question.Having thick skin is not an obstacle for rhinoplasty, but the healing process may take 1.5 to 2 years depending on the thin and normal skin structure.
It would be better face to face consultation.
Best Regards!

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have medium thickness skin, which is some of the most favorable skin to operate on. I can see that you have an overprojected nasal profile appearance, and a tension lip deformity. Rhinoplasty surgery may be considered for achieving a less projected, less distracting, and more feminine nasal profile appearance. If you have any issues breathing, they could be addressed at the time of surgery as well. Please consider meeting with several specialists whose practices focus on rhinoplasty surgery. I hope this helps! Sincerely, Dr Joseph

Lucian Ion, FRCS · Answer

Thank you for your inquiry and for sharing your photographs.

In a case like yours, deprojection of the nasal tip would typically require a corresponding reduction in the projection of the nasal bridge, along with a slight increase in the radix to maintain facial harmony. This adjustment can create a slightly elongated appearance of the nose in profile, which is why a degree of nasal tip shortening would also be necessary. While this shortening may subtly influence the contours seen from the front view, the nostril show can remain similar to the current appearance.

The extent of deprojection desired will influence the feasibility of achieving the ideal outcome. To facilitate a more productive assessment and provide tailored advice, I recommend a consultation incorporating computer imaging and simulation. This will allow you to define your goals more precisely and receive specific guidance on how the nasal tip’s soft tissue characteristics may affect the projected changes.

Overall, a certain degree of deprojection is likely achievable, and combining this with slight nasal tip shortening can create the overall impression of a smaller nasal pyramid.

Gary M. Horndeski, MD · Answer

In the frontal view, the width of the base of the nose is normal. However, in the side view, you can see the anterior projection is excessive. You would benefit from reduction of the anterior projection and slightly increasing rotation. You are at 90 degrees and should be at 110 degrees. This can all be done through an open rhinoplasty.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for nasal tip projection.   With good surgical technique, you could have an outstanding result.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag.  If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, or all patient selfie’s without real longterm in-office formal pictures that can also be a red flag.   Long-term results are much more meaningful than on table results or 1 week post-op results. Selfie’s can also be fun to look at, but these can often have a filter and do not represent true longterm results because of this and are not as valuable as real longterm in-office before and after photographs on your surgeon’s website.

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

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!My answer will be based on the limited information and pictures provided, for a detailed and personalized answer please consult with your plastic surgeon in person.
Plastic surgeons or facial aesthetic Surgeons that are trained to do rhinoplasty and feel comfortable with the procedure should be able to de-project your nose. I would always recommend that you go to a board certified or board eligible plastic surgeon for your face and body plastic surgery needs. The issue with thick skin is that a lot of the architectural work that the surgeon does might not show as much as opposed to individuals who have thinner skin but that does not mean that it cannot be done, there are a lot of things that can be done, before , during and after the surgery that can help highlight the changes and make them more obvious.I hope this helps, best of luck!

William Portuese, MD · Answer

The photographs are rather limited, but it appears from the side profile that you have an overly projecting nose and an under projecting chin. The Under projection of your chin makes your nose look longer than it really is. A closed rhinoplasty approach can accomplish reduction of the dorsal hump and some mild reduction of the projection, however, placement of a chin implant simultaneously can accomplish augmenting your chin forward MORE than the deprojection of your nose. Both procedures are complementary to each other with respect to facial balance and proportions. Digital computer imaging would be helpful in the education process for you.

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