Professional advice requested: Rhinoplasty. (photos)

In a early future im going to proceed with a Rhinoplasty: Lower Radix, Dorsal Hump reduction, Lateral Nasal Cartilages, Septoplasty, Batten Alar Graft, Medial Crus Alar reduction and Columella Strut Graft. BUT! After confronting several of my simulation pictures it seems like the reduction of Lateral Nasal Cartilages and Medial Crus Alares will make my nose looking short?! Should i lenghten my nose? Should i proceed with a Alar Rim Graft to adjust Retracted Alar?

Doctor Answers 16

Rhinoplasty: Focus on the Results, Not on the Technique

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These are my suggestions    1. Spend time figuring out what you want your nose to look like following your rhinoplasty. Focus on the result, not on the techniques needed to achieve it.   2. Choose two to four experienced, well-respected rhinoplasty surgeons in your area and make appointments to see them for a consultation.    3. During your consultation communicate what you want your nose to look like to the surgeon.         4. Have them use computer imaging to give you an idea of what they think your nose will look like following your rhinoplasty.    5. Look at before and after photographs of each surgeons work.    6.  Choose the surgeon who you feel understands your situation best and can give you the desired result.      7. Let the surgeon determine which techniques are needed to achieve the results you desire.      8. Be happy with your result.

Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 28 reviews

Rhinoplasty - Consult with a specialist

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The changes you describe can be achieved with rhinoplasty. If you want the best idea of what is possible for your nose, do your due diligence, find an experienced surgeon, and have him/her evaluate you in person and discuss your options. Looking at computer-morphed images with your surgeon during consultation will give you a good idea of what is possible, and also give you a great chance to convey to your surgeon what you envision.

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews


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You actually have an opportunity to have a great result. There is always that intersection between knowing too much and directing the show and trusting your plastic surgeon. It is healthy to be informed, but at some point you have to let them do their job. Find some one in your area who has a lot of experience with rhinoplasty and you like his or her aesthetics. Really look at their results and imagine if you would be happy with their outcomes. Best of luck to you.

Paul E. Chasan, MD
Del Mar Plastic Surgeon
4.9 out of 5 stars 46 reviews

Rhinoplasty candidate

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for more techniques the dura asking to have performed under nose increases the likelihood of a  disastrous result trying to over-engineer your nose.  She is her surgeon based on extensive experience with the procedure to give you the best results.  Minimal surgery will be best in your case

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Stop Being the Doctor

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Hello,I see you are from the Google University school, and believe you can give yourself an education in rhinoplasty so that you can tell the doctor exactly what you want. This is far from reality. You should instead pick your surgeon carefully, communicate what you want through digital imaging of your own face, and let the surgeon perform the details of the surgery. You think you've got a handle on this rhinoplasty thing but you really don't.  For example, you want to lower your radix, which is a good way to shorten your nose, yet you fear your nose will be shortened by something else. You really should let go of your preconceived notions and rely on your surgeon of choice.Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Professional advice requested: Rhinoplasty.

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Hello swedishvanilla - Thanks for your question.  It sounds like you have already had a consult with a rhinoplasty surgeon? I would agree with Dr. Perlman that less is more in your case.  I'm not sure why you would lower your radix.  It seems a little low to me in your photos (although they are not ideal photos), and will look lower after your dorsal hump reduction in my opinion. I think that the Alar Rim Graft concept will help but the change should be slight or you risk obliterating the view of your columella on profile. Any surgery to your tip should be conservative, and your osteotomies (bone cuts) need to be properly designed to give the streamlined shape to the bridge.  I don't believe that lengthening your nose is a good idea because it will visually alter the height of your young, beautiful upper lip. It may make sense to get a second opinion from another rhinoplasty specialist in your area.  LA has several. Good luck, Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews


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It is great to see that you have done your homework in regards to techniques used during rhinoplasty. It is always tough using simulation software because the software is not great at understanding what happens from one angle when you change something on another photo. I would recommend visiting with a few rhinoplasty surgeons who can go over with you what is possible and how augmenting one photo, would translate into changes in a different one. To answer your specific questions - no I would not recommend adding length or projection to your nose, and I would likely not recommend any rim grafts. Again, this would all depend on an in person evaluation.
Best of luck

David Reinstadler, MD
Newport Beach Facial Plastic Surgeon

Cosmetic rhinoplasty and alar grafts?

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Although I think you are very good candidate for cosmetic rhinoplasty it is my feeling that less may be more in your case.  Refining your tip, lowering your dorsal hump and possibly narrowing your nasal bones and nasal base would be beneficial.  It is not clear to me whether you need a columella strut without examining you and I personally would not suggest alar batten grafts or alar rim grafts. You will receive your best advice based on a face-to-face examination with a board-certified plastic surgeon so be certain that you are comfortable with your chosen plastic surgeon before proceeding.  Good luck and best wishes.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 reviews

Great candidate for rhinoplasty

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After reviewing your photos, I believe that you are a great candidate for rhinoplasty.  Although it appears that you have done your research, I do not believe that you need some of the maneuvers that you are considering.  My recommendation is that you consult with several Board-Certified plastic surgeons experienced in rhinoplasty.  They will accurately examine you, create a simulation to show you what you could look like after surgery, and tailor a plan that fits your individual needs and wants.


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Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. You may also benefit from a conservative dorsal hump reduction.  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.  Relying too heavily on computer simulation can be misleading and result in disappointment. 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.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 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.