Is it possible to slim/narrow down a bulbous nose without adding height to the bridge? (photo)

Question

I had a bulbous nose that I wanted to slim down from the frontal view, my nose bridge from the side is quite high and suitable for my face. I recently got a rhinoplasty to fix my bulbous nose and told my doctor I didn’t want any extra height, however he proceeded to add height, which definitely makes my bulbous nose look less bulbous and slim, but now leaves me with a witch-like/too high bridge that does not suit the Asian face. After I remove my implants, what can I do for a slimmer nose without height?

Goretti Ho Taghva, MD, FACS · Answer

Thank you for sharing your photos and posing your question!  It is not uncommon for patients to just want to narrow the tip of the nose and give it a more refined appearance instead of undergoing a full rhinoplasty with bridge augmentation etc.  In my practice, I like to use a combination of septal and ear cartilage to reconstruct the nasal tip.  It can definitely be performed without increasing the bridge height as long as you are ok with that fact that the tip would be higher than the bridge and you'd have more of a "scooped" appearance.  In order to give patients a more dramatic outcome, most Asian Rhinoplasty surgeons maximize the tip projection and therefore the bridge has to be raised to complement the high nasal tip.  Often times, the result may appear too fake, too masculine.  In your case, you have to find out from your surgeon what type of implants were used, and what type of cartilage grafts (if any) were used for your surgery etc. Removing the nasal implant can sometimes cause deformities on the bridge that needs to be addressed during your revisional surgery as well.  Hope that helps!Goretti H. Taghva MD FACS

Donald B. Yoo, MD, FACS · Answer

An Asian rhinoplasty specialist will be able to comprehensively address the issues you have with your nose.One thing to keep in mind though is that there is a limitation to the amount of tip refinement you can achieve (how small/narrow) because of the thickness of your skin. While there are a variety of approaches and techniques employed by various surgeons, it is up to you to do your due diligence to find a rhinoplasty specialist experienced in Asian rhinoplasty in order to achieve the best results possible. Using autologous grafts (tissue and cartilage from your own body) will provide the safest and most permanent results.Consult with 2-3 of these surgeons in person and determine your comfort level with their approach, demeanor, and before and after results. Good luck.

Philip J. Miller, MD, FACS · Answer

These are the most common issues I hear patients discuss with me regarding their reasons for wanting to alter the appearance of their nose while still maintaining their ethnic identity:
Asian rhinoplasty patients discuss their dissatisfaction with the following:
Flat nasal profileSlight nasal bridgeFlared nostrilsWide nasal tipPoor nasal tip strengthWhen selecting a rhinoplasty surgeon, it is of the utmost importance that you choose a surgeon who is board certified in facial plastic surgery. Board certification matters. Especially, when you are considering ethnic rhinoplasty. You want your face and nose in the hands of an experienced and qualified surgeon who can walk you through the procedure and cost.
I am including a website link about Asian Rhinoplasty as well as video that discusses in detail the specifics of this procedure. I hope you find this information helpful.
Sincerely,
Philip J. Miller, MD, FACS

Charles S. Lee, MD, FACS · Answer

If the septum was left alone during the initial surgery, then it can be used to build up the tip area only. Ear cartilage is sometime used to reinforce the septal cartilage. My strong preference is to use your own rib cartilage (1" incision under your breast crease) for maximum flexibility in reshaping the nose, but less invasive options are out there.

Ronald J. Edelson, MD · Answer

if you feel your bridge is too high it can be lowered by removing whatever was used to build up the bridge.  I actually think you have a good result but you should discuss this with your surgeon.

Harold J. Kaplan, MD · Answer

Hello,If you are not interested in a surgical tip correction, then using filler would be the only other option.  The idea is to use a small amount of filler that extends from the spine of the nose to the very tip.  This gives the appearance (illusion) that the tip is more narrow and smaller.  Of course, contouring with  make up is an option, but filler has been known to be a good alternative to surgery when surgery is not an option for the patient.  One syringe of Restylane ($495) makes for a good investment with no downtime and approximately 9 to 12 months duration if not longer.The below link offers more info and before/after photos.

William Portuese, MD · Answer

It's important we at least one year before undergoing a revision  Rhinoplasty  to allow full  healing to take place before embarking on another procedure.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,You can make your tip less bulbous without removing the implants. The tip needs to be de-fatted and tip grafts inserted to give your tip more shape and structure. Feel free to send your photos for computer imaging to see what your tip can look like after a revision procedure.Best,Dr.S.

Is it possible to slim/narrow down a bulbous nose without adding height to the bridge? (photo)

Answers (8)

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