Glabella/radix/bump reduction: are my desired results attainable? (Photos)

You are certainly a good candidate for a rhimoplasty.  It’s obvious by your question that you want a small nose.  Nowadays many surgeons are quite conservative in their reductions.  You should look at before and after photos where you see results you like or may be similar to you. That may help guide you.k

Please realize there is a limit as to how much a radix can be brought down. It also depends on the overall contour of the nose to make it look "natural."
Don't try to overdo the reduction!

Hello,A high radix is easily managed with a power tool that looks a lot like the Dremel, which spins a burr at high speed to take down nasal bone, giving relief from the glabellar portion of your frontal bone, as seen on all your goal photos. Go visit a few ABPS certified/ASAPS member surgeons (or the AAFPRS equivalent) who specialize in rhinoplasty. Best of luck!

Click on the "Learn more" link, just below my response, or go here:
FacialSurgery.com/RealSelf/RealSelf_spoilers11.html
I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands.You are absolutely correct, that if your bump is taken down, the radix must be deepened as much as possible, or your profile will end up resembling a Roman statue's profile, with the forehead sliding right down onto the bridge:FacialSurgery.com/RealSelf/RomanStatue.jpgThe tip of your nose is also strongly forward projecting from your face, so in the morph, I brought the tip back. In the animation, you'll see that de-projecting a nose like that tends to allow the upper lip to relax a bit. The woman in the short video that I posted with this answer had a strongly-projecting nose.Then, I elevated the tip: your models' noses are very short. Very nice, I think, so that would be a goal for your nose as well. Some of those models' noses, though, are really very very small in their radix projection and the height of the upper part of the bridge. It probably wouldn't be possible to get that small on your nose, given where your anatomy is starting, but the goal would be to get as close as possible.
You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon. Rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. 
I'd love to hear what you think of the morph. Did it seem to address your main concerns? I could modify the morph to your taste if you wish.
Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who understands all of the issues I mentioned, and how they fit together, and who can actually accomplish them in surgery. 

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty.  You may also benefit from a dorsal hump
reduction with some deepening of your radix.  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.
The most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Dear spoilers11 in Huntington Beach, California:
          You are wise to be thinking about rhinoplasty because I think it would be a positive endeavor for you.  However, the question is how much the root of your nose and the bump can be lowered to satisfy you.  I would recommend consultation with very experienced rhinoplasty surgeons.  The decision is made on the examination because there are many factors that have to be considered.  There is a limit to how much you can lower it because the root of the nose actually is comprised of both the nasal bones, which are easier to lower, but also the frontal bone of the skull, which is much thicker and heavier and therefore more difficult to “shave down.”

You want to do your homework before consultation.  Prepare well for your consultation.  When you search, look for rhinoplasty super-specialists.  These are surgeons whose practice is the majority or entirely devoted to rhinoplasty, septoplasty, and related procedures.  This would include both primary and revision rhinoplasty surgery.  Why not have the most specialized talent in your service?  Consider how much experience the surgeon has doing the procedure you are considering. We all get better at what we do with time and so those surgeons who have a long run of experience are the ones who have learned the most from experience. Residency and fellowship are where the learning begins, but for all of us, time and experience is where the education continues.

Part of your preparation for consultation should be preparing a list of questions beforehand.  Bring a notepad or ipad or laptop with you and take notes as the surgeon answers the question you are asking.  You should spend more time with the surgeon than with the office administrative staff, because you need to get a sense of whether you are comfortable with the doctor.  You should not feel rushed that you are on a consultation conveyer belt.  If the presentation by the office staff seems a bit to “salesie” that is a bit of a yellow or red light.  Take a friend or relative along since two heads are better than one in gaining information and understanding.  In the end, the purpose of the consultation is for you to be educated and be comfortable, not to be “ sold”.  Ask yourself two key questions: “Is this surgeon teaching me or selling?” And secondly, “Can I put my life and my face into this particular surgeon’s hands? Can I trust him/her?”

There are excellent books out there that you can read and use to study up. It is worth the homework time you put in up front so that you make the right decision with respect to choosing a surgeon who has the talent, experience, and degree of super-specialization that you certainly want to have. 

When you visit doctor’s websites, the most important feature on the site is the before and after gallery.  If there are just a few examples of rhinoplasty or revision rhinoplasty, you wonder how much experience the surgeon has performing such surgeries.  There need to be dozens and dozens of examples.  The more examples there are, the more likely you will see one or more that demonstrate situations similar to yours.  Look closely at the photos for natural results.  That is what you want.  Nobody wants to carry a sign saying “I have had a rhinoplasty.”

     Reviews on review sites, particularly RealSelf are very important and should be carefully digested. The larger the number of reviews the most accurate the picture of the practice and particularly the doctor. A consensus is generally correct.

   A consultation without computer imaging is, in my opinion, of much less value.  Why shouldn’t you see the predicted result of the procedure the doctor is proposing?  At consultation, photos are taken of you and loaded into a computer system that morphs your present appearance into the anticipated “after” based on the nasal surgeons input.  Imaging is an incomparable learning tool because it provides a forum for doctor and patient agreement on what would satisfy the patient and what is, in the doctor’s opinion, achievable.  After all, cosmetic surgery is 100% visual. 

It is about appearance, so without a visual evidence of what is planned, how can you make a decision as to whether or not you might be satisfied.  Talking about it is worthless.  To anticipate a successful outcome, there must be a meeting of the minds between surgeon and patient.

     Best wishes,

 

Robert Kotler, MD, FACS

Over 4,500 nasal procedures performed

Your wish photos all show a pleasing curvature on a relatively petite nose. I do think you could achieve that but would need to see more views and examine you personally to assess your skin thickness, the takeoff point of your slope, and other considerations. Usually a burr (rather than just a rasp) device is needed to lower the radix significantly, and you may need osteotomies (controlled breaks of the sidewalls of the nose) to make sure you don't have an "open roof" of your nasal vault after reducing the top.

The areas that concern you
can be realistically cosmetically improved with an artistically performed natural appearing rhinoplasty.
Keep in mind that following
advice from a surgeon on this or any other website who proposes to tell you
exactly what to do based on limited two dimensional photos without examining
you, physically feeling your tissue, assessing your desired outcome, taking a
full medical history 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 suggest that you find a surgeon certified by
the American Board of American Plastic Surgery and one who is ideally a member
of The American Society for Aesthetic Plastic Surgery (ASAPS) or facial plastic
surgeon (otolaryngologist) that you trust and are comfortable with. You should
discuss your concerns with that surgeon in person.
Robert Singer, M.D., FACS
La Jolla, California

 Digital computer imaging of your nose upon your facial features would give you a very good idea what can be accomplished with the rhinoplasty procedure. It is possible to lower the radix and glabellar  which is just an extension of the dorsal hump itself. You will also require  medial and lateral osteotomies placed in the nasal bones. A closed rhinoplasty can accomplish your goals with all incisions placed on the inside. No external Incisions are required. Seek out a very experienced rhinoplasty surgeon for best results.

Thank you for the question and photos and I would go on some complimentary consultations with experts who use digital photography to show you what can be accomplished with your nose and how it might be done. That way you will be fully informed about the desired procedure.Dr Corbin