Is it possible to make my broad square-tipped nose look narrower? (Photos)

Question

My nose is not proportional with my face and features. It has a wide unshaped tip and the nose wings are too wide. Looking at it from below it has a square shape and from above it is asymmetric with one side longer than the other. The profile is too upturned showing too much the nasal holes. I'd like to have the wings less wide, the tip narrower to the size of upper third and the profile more downward. I would very much appreciate the advice of a surgeon to know if my wishes are possible or not.

Steven M. Denenberg, MD · Answer

You have strong tip cartilages that make the tip look wide.  There is  a little bump on the bridge. But lowering the tip is very difficult to accomplish. But it's probably not so necessary. If the forward projection of the tip is reduced, which might be good for your nose, the nose tends to look longer, even if the tip isn't specifically lowered, a procedure that is difficult and not highly predictable to accomplish.
How *much* to narrow the tip, or deproject the tip? And will it get you where you want to be? 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.)
Finally, 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 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?

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 which can be performed by trimming, suturing, and reshaping the cartilage in your lower nose. This can be designed to help improve the symmetry of your nose.  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

Toby Mayer, MD · Answer

Rhinoplasty for a more feminine and attractive appearance. You will need a very slight hump removal, tip narrowing , and a septal extension graft, nostril narrowing, etc  Make sure you see several VERY experienced rhinoplasty surgeons who can show you many examples of natural results to prevent ending up with a pig nose

Michael A. Persky, MD · Answer

Hi I,This is a common reason many patients undergo rhinoplasty. flattening out the boxy and round shape to your tip cartilages will improve your tip shape and create the narrowing you're seeking. Your skin appears to be on the thinner side and this should be strongly considered by your surgeon at the time of surgery. Seeking a qualified rhinoplasty specialist is important to maximize your outcome. Consult with a few rhinoplasty experts and then be sure to choose your rhinoplasty surgeon carefully based on their skill, knowledge, training, care, and most importantly their natural artistic vision and results. A few rhinoplasty masters that I would recommend are Dean Toriumi, MD (Chicago), Steven Pearlman (NYC), and Ari Hyman, MD (Los Angeles.) Good luck and be well.Dr. PerskyEncino, CA

Gerald Minniti, MD, FACS · Answer

You'll need a rhinoplasty that can provide support by lengthening the septum with stiff cartilage grafts to de-rotate the tip, as well as tip defining sutures to diminish the boxy shape of the tip.

Tanveer Janjua, MD · Answer

You need the following changes to achieve the results you're requesting.1.  Alar plasty2.  Tip plasty3.  Conservative dorsal hump reductionPlease be aware that asymmetries very difficult if not impossible to correct.  The degree of asymmetry you notices very  minimal and is unlikely to be corrected with surgery.RegardsDr. J

Victor Manuel Agudelo, MD · Answer

Hello. 
You are a very good candidate for a rhinoplasty, and the changes you wish are achievable. 
Computer simulations can help, but better look at before and after pictures of similar cases as yours done by your surgeon.

Serhan Derin, MD · Answer

Hello, 
With a rhinoplasty operation (doesn't matter closed or open), you may own smooth and curvy nasal vault, thin nasal tip and less protuberance the columellar show. 
I strongly advise that you should assess before and after photos of the surgeon's patients. While searching suitable surgeon, it can be benefit you.
Sincerely,

William Portuese, MD · Answer

A closed rhinoplasty procedure  can accomplish shaving down the dorsal hump, refining the nasal tip cartilages with suture techniques or conservative cartilage removal, and reducing the columellar show.  All incisions are placed on the inside of the elbow.  No external incision is required and no painful packing required.

Anthony Bared, MD, FACS · Answer

It does appear in your case that refinements can be made to the shape of your tip.  The tip cartilages can be narrowed and brought together to provide you with more tip refinement.  Techniques would need to be implemented to narrow the tip but also preserve the support needed in the tip cartilages.

Is it possible to make my broad square-tipped nose look narrower? (Photos)

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