Ugly side profile, how to improve? What procedures would balance my face? 23 years old and weigh 49kg. (Photos)

Question

From the front, I'm ok with my face, but from the side, I hate it. What procedures would balance my face? I was thinking a chin implant; I have a slight malocclussion with overbite, but my dentist says it's too slight to consider surgery. With regards to Rhinoplasty, can my nose be made to slope downwards, like a right angle, as I seem to have a really low bridge and I fear getting the hump removed will flatten my profile even more? Thank you for any answers, any advice is highly valued!

Philip J. Miller, MD, FACS · Answer

Your nose and nasal hump can be improved with rhinoplasty. I would recommend starting with a consultation with a board certified facial plastic surgeon that specializes in rhinoplasty surgery. 
I would recommend writing down the following questions before scheduling your consultation:
1. Are you unhappy with the tip of your nose? 
2. Do you feel that your nose is too wide? 
3. Do you want to make your nostrils smaller in appearance? 
4. Are you looking to decrease the general size of your nose?
I hope some of these questions will help you pinpoint what it is that you don't like about your nose.  Cost will vary due to many factors including: facilities fee and anesthesia fee. I wish you the best as you research your options when scheduling a rhinoplasty consultation.
Sincerely,
Philip J. Miller, MD, FACS Double Board Certified Facial Plastic Surgeon

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty and a nasal tip deprojection to make the overall size of your nose smaller.  A chin implant can be performed at the same time for
improved jaw line contour.  I always use a medpor implant with screw
fixation, which stays in place over time.  A silicone chin implant has a
high rate of malrotation over time.  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

Adam Bryce Weinfeld, MD · Answer

I agree a rhinoplasty could help to soften your profile view.  I recommend you consult with a plastic surgeon to discuss your goals further. Often you surgeon will be able to morph your photos to give you an idea of your appearance post surgery.

John Harbison, MD · Answer

Emily,    Thanks for your question.  You are spot on with a lot of issues.   I think only taking the hump down would leave the nose too flat.  In your case some augmentation of the radix area (often with fascia or cartilage) along with slight bump removal are helpful.   It is important to maintain harmony with the nasal tip which may change with surgery depending on your goals, and some standardized photographs.  Regarding the occlusion and chin, I do think the chin is underprojected.  And you may benefit from a small chin implant at the time of nasal surgery (this is fairy common).  Balancing the chin with the nose will make the nose appear smaller and give a good balance to the face.  A consultation with standard photographs and an exam is best to give more details about what might be best in your case.Good luck.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi Emily!I would recommend consulting with at least two board certified facial
 plastic surgeons. Following is what to be prepared to ask for during 
your consultations:
1. Ask about his/her experience performing rhinoplasties.   This is 
important to know since you want to ensure that the doctor has performed
 enough rhinoplasties that he will be able to handle any issues that may
 occur during your surgery. But don’t rely on numbers alone. Someone who
 has learned to tie their shoes incorrectly may tie them that way a 
thousand times. But someone who learned to tie shoes correctly may have 
only tied them a hundred times. 
2.  Talk to previous patients. Your plastic surgeon should give you 
the names and contact information of previous patients who have 
undergone a procedure similar to the one you’re considering. Finding out
 what a patient has experienced and how she feels about the results can 
set your mind at ease and give you a good idea of what to expect.
3. Request computer imaging. Computer Imaging allows one to preview 
one’s surgical results BEFORE the surgery.   One of the newest and most 
illustrative tools that surgeons can now employ is the use of 
computer-generated imaging (CGI) to illustrate the anticipated results 
of a Rhinoplasty procedure. In previous years, both surgeon and patient 
had to wait until the post-surgery swelling in the nose receded to see 
if the procedure's results met with their expectations. Today, surgeons 
can illustrate what the post-surgery nasal structure will look like with
 the click of a computer mouse.  You can also use the computer imaging to show possible results for the chin implant and any other features you'd like altered. 
4. Get the surgical gameplan.  Every surgeon works in his/her own 
way.  The consultation is the time to ask questions about what to expect
 during surgery: What does your surgeon plan to do and how does he/she 
plan to do it? How long will the surgery last? What type of sedation 
will be used? Will the surgery be performed in her office or at a 
hospital?  How long will it take to recover?  How soon after surgery can
 you go back to work or exercise?  How will she handle your pre- and 
post-operative treatment?  What is included in the cost of the surgery 
and what, if anything, might be extra? Information should be explained 
to you in easy-to-understand language. If you don’t understand 
something, ask questions.
5. Discuss potential risks and complications. 
Assess your comfort level.  Once you have meet with prospective 
plastic surgeons and interacted with their staffs, you have a pretty 
good understanding of how plastic surgery can enhance your appearance 
and what the doctor can and can’t do. You may have come to the 
realization that each surgeon you consulted reached similar conclusions 
about your surgery and the results you can expect. The computer images 
you viewed may have been quite similar, too.  Take a deep breath and 
examine your feelings about rhinoplasty and the surgeons you’ve met. 
Good luck! 
Dr. S.

Harrison C. Putman III, MD (retired) · Answer

Looking at your profile, I agree that modest hump reduction is advisable to create a more feminine appearance. In addition slight tip deprojection and cephalic (upward) rotation will also help to balance your profile. I do not think you need chin augmentation with these changes, as you nose will be more in balance with your overall profile. Good luck!

Ugly side profile, how to improve? What procedures would balance my face? 23 years old and weigh 49kg. (Photos)

Answers (6)

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