What procedures would give me the desired nose shape? (Photos)

Hello and thank you for your question. It sounds like your biggest concern is your nasal dorsum and nasal tip, particularly the shape and the asymmetry of this and your nostrils, as you mentioned. Addressing the shape of the nose (particularly to the dorsum and the nasal tip) is one of the most common reasons people seek out and undergo a rhinoplasty procedure. An open septorhinoplasty can best address the entire nose, and is particularly effective for reducing the nasal dorsum, and giving you this nice supratip break you're seeking.

In addition to addressing your aesthetic concerns, your septal cartilage (or an off-the-shelf alternative) would be harvested (removed) and turned into multiple cartilage grafts, which would then be secured into different areas of your nose for structural support, including in the columella (middle bottom portion of your nose between your nostrils) to really reinforce the tip and prevent recurrence of the asymmetry.

The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery. I would only recommend going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.

Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos and description provided.

Dr. Donald Groves, our expert facial plastic surgeon, has extensive training and experience with complex rhinoplasty surgeries, so I’d recommend for you to come see him (or another plastic surgeon who is extremely comfortable with rhinoplasties) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Emer

I believe the photo on the right is a computer simulation of your nose with a lower nasal bridge appearance. If this is something that you would wish to achieve, rhinoplasty surgery may be considered. In that regard, please consider meeting with several reputable rhinoplasty specialist who offer computer imaging so you could see what to expect moving forward. Thank you for your question. Sincerely, Dr. Joseph

To achieve the image you are showing, the bridge can be taken down some and the tip projected better. I'm not sure if the bridge can be taken down that much, but upon exam, we can determine if will look natural or not. It is important to find a rhinoplasty expert for consultation.