Is it possible to keep a bit of the bridge of this nose yet make it less (if possible not) crooked. (photos)

The length,size,droppiness,crookedness, ...are the problems. The right side of it looks kind of OK (the last photo) but the left side of this nose is ridiculous. As I said I want it fixed but I don't want a completely flat nose. What kind of route would you follow. Does it require breaking or just shaving. Thanks.

Doctor Answers 6

Yes, rhinoplasty will lower the bridge and that may contribute to the nose looking less crooked.

Dear reallamb in Los Angeles, California: Right size, droopiness, crookedness being a problem is not unusual.  Crookedness is usually due to deflection of the septum and so a good consultation will include a careful evaluation of the inside of the nose to see if there is crookedness to the septum and also if that is causing any airway blockage.  This is very important.
Regarding a flat nose, you will not have a flat nose with a standard rhinoplasty procedure performed because after the bump or high bridge is taken down, then the bones are gently manipulated into a narrow position to recreate the natural anatomy.  It is hard to say whether yours could be done “just shaving” or whether it would require “breaking.”  That is something that certainly can be answered at the consultation.    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?  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 2 heads are better than 1 in gaining information and understanding.  In the end, the purpose of the consultation is for you to be educated and be comfortable.  Ask yourself 2 key questions: “Is this surgeon teaching or selling?”  And secondly, “Can I put my life and my face into this particular surgeon’s hands?  Can I trust him?” 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.” 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

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 87 reviews


Dear Reallamb, Yes it is possible to refine your nose and address your concerns while still providing a very natural looking nose that balances well with your facial anatomy. During consultation digital imaging can be performed to show you the proposed changes and at that time the surgeon can discuss all of the techniques which will be used to attain the desired result. You can also review many before and after photographs of noses similar to yours and ensure that the surgeon performs natural looking rhinoplasty results. I have included a video above of a similar nose and a link below of further examples of natural looking rhinoplasty results. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews

Rhinoplasty for the correction of the long nose.

An in person examination is needed to determine your goals and what the problems are. Without these i would just be guessing.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Rhinoplasty procedure

A  closed rhinoplasty procedure can accomplish straightening the crooked nose by placement of osteotomies in the nasal bones. Sometimes a spreader graft is required to be placed underneath a concave upper lateral cartilage in the midportion of the nose. The length  can also be reduced, the dorsal hump shaved down, the  hanging columella reduced and the tip of the nose lifted. It's also important to release the depressor septi ligament which pulls the tip down when smiling. For many examples, please see the link and the video below 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews


You can reduce the size and still maintain most of your bridge.  It will require osteotomies (breaking the bone).  In-office imaging can help you to visualize what is possible.  Best wishes.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

Is it possible to keep a bit of the bridge of this nose yet make it less (if possible not) crooked.

The nasal areas that you described and would like improved can be addressed with a nasal surgery (rhinoplasty) and a probable septoplasty which are typically done at the same time. A natural appearing nose can be achieved when the procedures are performed by an artistic plastic surgeon with extensive experience in nasal surgery.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do and technically how to do it based on a limited two dimensional photo without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and 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

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.