Am I a good candidate for a rhinoplasty? (Photo)

Question

Ever since I was in high school o really disliked how my nose dropped when I smile and how it gets wider. I like the slope of my nose just not my tip.

Semih Yildiz, MD, FEBOPRAS · Answer

Your concern sounds mainly dynamic: the tip may rotate downward and the nostrils may flare when you smile. The photos cannot determine whether this is due to depressor septi nasi or alar muscle activity, cartilage and skin anatomy, or simply normal expression, so candidacy cannot be decided from images alone. If the nose looks acceptable at rest, a specialist might discuss a very conservative, temporary botulinum-toxin treatment for selected muscles; it must be placed precisely and can cause an asymmetric smile, upper-lip weakness, or other unwanted changes. If drooping or widening is also present at rest, limited surgical options such as tip support/rotation or alar-base modification may be considered, but they carry risks and could change a nose you otherwise like. Please see a board-certified facial plastic or plastic surgeon for an in-person exam, including your breathing and stable goals, and bring both resting and smiling photos or video. Do not proceed based on these photos alone.

Anil R. Shah, MD · Answer

Hello,

In order to see if you are a good candidate for a rhinoplasty, it is important to set up a consultation with your preferred plastic surgeon. During this consultation, you can determine if you are a good candidate and decide what you would want your new nose to look like.

Eric M. Joseph, MD · Answer

Based on your photographs, I can see that you have relatively thin nasal skin and a droopy nasal tip appearance. For some reason, your photographs appear distorted when they are clicked on. In general, rhinoplasty techniques are often employed to rotate a droopy nasal tip appearance. Rhinoplasty techniques may also be used for narrowing a wide nasal tip. Thank you for this question. Sincerely, Dr Joseph

William Portuese, MD · Answer

The photographs are rather limited, but a closed rhinoplasty approach can accomplish refinement of the nasal tip, narrowing the bridge line, and preventing the tip of the nose from drooping dynamically when smiling by releasing the depressor septi ligament. All of the incisions are placed on the inside of the nose. No external incisions and no painful packing is required.

Gary M. Horndeski, MD · Answer

You are an excellent candidate for a rhinoplasty.  The tip of your nose is too wide, the cartilage needs to be brought closer together and the lip-nose angle is too acute.

Best Wishes,

Gary Horndeski, M.D.

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. 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. Tip elevation and tip deprojection could also be performed at the same time. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Erin Smith, MD · Answer

Thank you for the question. Based on review of your photographs, it does appear that you may have some degree of nasal ptosis. You may notice changes in the appearance of your nose with facial muscle movement. In order to fully understand your goals, it would be beneficial to have an in person consultation with a facial plastic surgeon who can guide you through the process and identify any other concerns you may have.

Kenneth R. Francis, MD, FACS · Answer

Dear Trustworthy,
The nose, as you have pointed out, is a dynamic, as well as, a static structure.  The dynamic nature of nasal shape changes cannot be well captured in still photographs.  An in person evaluation would be required to assess your nasal proportions and the nature of your concerns.  From the photos, you appear to have a very nice nose.  Good luck!

Pawel Szychta, MD, PhD, DSc · Answer

Based on your concerns about your nose tip dropping and widening when you smile, you may be a good candidate for rhinoplasty. This surgical procedure can refine the nasal tip and adjust muscles to prevent it from drooping during facial expressions, all while preserving the slope of your nose that you like. Consulting with a qualified facial plastic surgeon will provide a personalized assessment to determine the best approach to achieve your desired results.

Am I a good candidate for a rhinoplasty? (Photo)

Answers (9)

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