Is there a way to fix my side profile (bump on my nose and large overbite)? (Photos)

Question

I have have a bump in my nose, and I have a very large overbite (my teeth do not rest on top of each other when I rest my jaw) so my chin juts out as well. My side profile is my biggest insecurity.

Lucian Ion, FRCS · Answer

Your bite is not immediately clear in the photographs. The alignment of the upper and lower lip and the area under the nose suggest reasonable proportions. If you are considering jaw surgery you would need to address this question to a maxillofacial specialist, but from the photographs it seems unnecessary.A chin reduction is definitely possible and can help to balance out the profile. It would be necessary to evaluate on a cone beam CT scan the characteristics of the mandible and chin in order to plan this type of intervention.For the characteristics of the nose a combination of reshaping and reduction could help along the lines of the goals have set out. A degree of shortening of the nasal tip would also help the impression of downsizing for the nose. The semi-profile or oblique view identifies relatively low position of the tip defining points through the characteristics of the curvature of the tip cartilages, and moderately wide appearance of the nasal tip. They can both the corrected in surgery.In order to establish parameters that you feel comfortable with a computer simulation in 2D and 3D would be able to bring together both the parameters related to nasal and chin reshaping.

Steven M. Denenberg, MD · Answer

Yes, I see the bump, but actually, I notice a couple other things to address as well.It seems that the two cartilages that form the tip of your nose are very strong, and they do a few things to your nose. They make the tip look wide-ish. You see that on the three-quarter view much more than on the profile view, which is typical.The woman in the short video that I posted with this answer had the tip of her nose narrowed in her operation.Those strong tip cartilages also typically hold the tip down, so the nose looks long, long from top to bottom. We see that on the profile view, but we also see it on the three-quarter view. I think it would look good to elevate your tip.In fact, it's probably really necessary, if you have surgery. The reason is that when a bump is removed from the bridge, it tends to make the nose *look* longer, as if the tip had dropped. If you have only that change, and the nose looks longer, you might like it less.
How *much* to elevate the tip, or lower the bump, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should always be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and only the surgeon has that information and judgment. Another aside: I also recommend that you not show morphs made by one surgeon to a different surgeon. If a surgeon makes his *own* morphs, you get to see whether he understands the important issues of your nose, and how your nose should be changed. But if you show the surgeon someone else's morphs, and he says "Of course I can make your nose look like that," then you don't really know if he fully understands, or even recognizes, the important changes shown in those morphs. And you don't know if he can make those changes during surgery.)
Remember that 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. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.
Your nose is also a perfect example of why computer imaging by the operating surgeon 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. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, 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 large 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?When it comes to the jaw surgery, I see a very prominent chin, but I can't tell if you have an "overbite", which refers to how the teeth fit together. Don't have any jaw surgery unless you have a teeth-fitting-together problem that can't be addressed with braces--it's a big, big operation that is only rarely reasonable for cosmetic changes. There may be a way to make your chin smaller, if that bugs you, with oral surgery, but that could possibly be done without moving the teeth, which is much better. Don't let someone do an operation, though, where he just goes in and buzzes down the front of the chin a bit: it's very hard to make any change at all trying that!

Lydia Badia, MD · Answer

Hello. Thank you for your picture. You can benefit from a rhinoplasty surgery to remove the bump however, I suggest you to consult a specialist in facial surgery. You will have to evaluate your facial proportions and consider what would be the best approach.

Suleyman Tas, MD, FEBOPRAS · Answer

Hello,Thank you for your question. The best advise on the improvement of your side view you will get from the detailed examination by an experienced Board Certified plastic surgeon. Based on your pictures you may benefit from the shortening of your nose, dorsal hump removal and refinement of the droopy tip, preferably with the Closed Technique where all incisions are placed inside the nose. Rhinoplasty is a complex surgery which requires extended experience, knowledge and skills. Therefore make a good research before deciding for a surgery. To find out more before and after pictures please visit the attached link.Best regards

Ronald J. Edelson, MD · Answer

I think a rhinoplasty would be fine. It is not apparent to me what is going on with your bite. For that it is worth consulting a dental professional , preferably an orthodontist.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty, a cephalic rotation of your tip to turn up your tip slightly, and a dorsal hump reduction. Jaw surgery may also be appropriate for you, but this would require a detailed in-person evaluation. 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

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Behrad Elmiyeh, MBBS, MRCS, FRCS (ORL HNS) · Answer

Thank you for your questions and for sharing your photographs.

You have a mild dorsal nasal hump and an acute nasolabial angle of about 90 degrees. It appears that you have a bulbous nasal tip but there is no front view photograph to assess this fully.

You will benefit from having a rhinoplasty to reduce your nasal hump and to improve your nasolabial angle to a more feminine angle (95 to 105 degrees). You may also require nasal tip refinement.

Rhinoplasty is one of the most delicate and complex cosmetic surgeries, given the intricate structure of the nose and the balance it provides to a face.

There are limitations based on the individual's nasal anatomy and the nasal skin quality. For example, you have a good quality thick nasal skin which is great in covering up minor irregularities but since it does not shrink well after surgery, it will not show fine underlying refinements to the same extent as those with the thin skin.

I would suggest that you consult with an expert rhinoplasty surgeon and discuss what you do and do not like about your nose.

You should expect a full detailed examination of your nose is required to assess your nasal skin, cartilage, bony structures, and your nasal airway/ breathing. This will allow the surgeon to evaluate your nasal appearance and its relation to your facial features.

The use of manipulated (morphed) digital clinical photography provides a platform for discussion as to your desires and expectations. Such images are not a guarantee of exact results, but a great tool to ensure that you and your surgeon are on the same wavelength.

It is paramount that you have a realistic expectation before proceeding with this surgery.

Best wishes,

Is there a way to fix my side profile (bump on my nose and large overbite)? (Photos)

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