Can you answer my concerns about rhinoplasty? (photos)

I just want your honest feelings,(vagueness is fine)Would you feel open or closed rhinoplasty?Would nose be broken 1st? Nose curves towards right,nose skin is oily with blackheads,should that influence result? Does this seem a very complicated,difficult surgery on my nose? Also I'm 50 y.o.

Doctor Answers 12

Rhinoplasty Is Often Complex

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When it comes to rhinoplasty, there's really no such thing as a simple procedure. However, with your clearly defined goals and realistic expectations, you seem like an ideal candidate. Often, straightening the nose does require a controlled break. The "oily" nose skin you describe is quite common, and it has no effect on your result. It's difficult to tell whether your surgery will require an open or closed approach without an in-person consultation. In any case, you can expect your resulting scar to be quite discreet. 

Tucson Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Rhinoplasty is not a simple procedure

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Thank you for the photos that you have provided.  You are an excellent rhinoplasty candidate.  You have clear cut ideas of what you would like to see improved in the appearance of your nose and these changes can certainly be accomplished. You also have pointed out some of the issues with your nose that can effect the outcome of the surgery such as thick and oily skin which will decrease the ability to create a highly sculpted nasal tip.  You are certainly age appropriate and your rhinoplasty can be performed open or closed.  I suspect that you will need osteotomies (breaking the bone) in order to straighten your nose if it is crooked.  Good luck!

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Rhinoplasty can make a nice improvement...

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I never call any rhinoplasty simple, but you should be able to have a nice improvement with a well performed rhinoplasty. I would most likely perform an open rhinoplasty to reduce the bump and better define the tip, while at the same trying to straighten the nose. The thicker skin on the tip hinders the refining process a bit, but you should still have a nice improvement. Age doesn't matter for the procedure as long as you are healthy.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 222 reviews

Can you answer my concerns about rhinoplasty?

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Thank you for your question and photo, 1. Open Rhinoplasty2. That said, there are considerable amounts of people who suffer from loss of self-confidence due to psychological implications. As with other cosmetic surgical operations, we approach cosmetic nose surgery in relation to the entire face and carefully consider its medical and cosmetic results. Although the nose is an organ that affects facial aesthetics right in the middle of the face it should definitely be approached in a way that is in proportion and coherence with the entire face.

Bulent Cihantimur, MD
Turkey Plastic Surgeon
4.8 out of 5 stars 102 reviews

Cncerns about Rhinoplasty Surgry

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If you want to remove the nasal hump and straighten your nose osteotomies (breaking the bones) will be necessary. I consider all rhinoplasty surgery complicated; it is the most challenging cosmetic operation that we do. Your surgery can be done using the open or closed technique. Age is not important as long as you're in good health; it is not rare for me to do a rhinoplasty a the same time as a facelift. Treatment of your oily skin with blackheads will improve your rhinoplasty results.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Closed rhinoplasty approach

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A closed rhinoplasty approach can accomplish shaving down the dorsal hump, straightening the nose with osteotomies, decreasing the projection of the nose and refining the tip. When performing the dorsal hump removal, an open roof, flat top nasal deformity will be created, therefore the osteotomies are placed in the nasal bones in order to break the nose  inward to a more narrow position and close the open roof. Rhinoplasty is one of the most complicated operations to perform  in all of cosmetic surgery, so choose your surgeon very wisely based on extensive experience. For more information and many examples of noses similar to your own, please see the link below to our closed rhinoplasty photo Gallery

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


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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 spreader grafts to help straighten your nose and a conservative dorsal hump reduction. 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

Open vs. closed rhinoplasty

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For me it depends on what you are trying to achieve.  If you like the general shape of your tip, then I would probably offer closed rhinoplasty.  Not that tip shaping can't be done via closed rhinoplasty, but I feel that I have better control of the result with the open approach for certain tip work.  Being 50 doesn't really matter as long as you are healthy enough for surgery.  I would also throw out the concept that the older patients are when they have rhinoplasty, the more they have established their sense of facial identity, and the more possibility that they may have a harder time emotionally adjusting to their new look.  Because of this, I would recommend being conservative with the surgery (more than usual).  

Matthew Bridges, MD
Richmond Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Good candidate for rhinoplasty

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determining who is a good candidate depends on desired result as well as the preoperative tissues. Your skin does not look overly thick and your deviation is not extreme. Tip cartilages are convex, which can be difficult to eliminate fully. Understanding that this may be a limiting factor for degree of narrowing, you should be considered a good candidate for surgery. 

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 55 reviews

Your nose

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When done by a skilled surgeon , your surgery should be routine. I do closed rhinoplasties most of the time, as far as exactly what needs to be done, that would be determined at your in person consultation.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 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.