Should I have an open or closed rhinoplasty? What do you suggest be done to make my nose more attractive? (photos)

My nose is quite narrow and long but with flared nostrils and a bulbous tip. The bridge is very flat and has a bump. I'd like to maybe add cartalidge to my bridge. I want my tip to be more defined and my nostrils to be a bit more covered. I think if the columella were pushed up it could fix some of the problems above. I also don't like how long my columella is. Please let me know your opinion of how it could be shaped.

Doctor Answers 14

Rhinoplasty, Toronto Plastic Surgeon, Dr. Adibfar

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Hello ; 

Based on the photos you have submitted and your overall facial and nasal proportions you may need very little refinement,  if any , to your nose.

You may benefit from either subtle reduction of your minor dorsal hump or an augmentation just above that .

A subtle refinement of the tip and  repositioning of the collumella may also answer your wish list.

The type of approach really will not matter in the final result .

A comprehensive in person evaluation would be necessary to come up with a detailed treatment plan and answer all of your questions. 

Thank you

Should I have open or closed rhinoplasty?

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A closed rhinoplasty approach can accomplish making the required changes to the nose with all of the  incisions placed on the inside of the nose. There's no  external incisions required. The Nostrils can be reduced  and the bulbous tip reduced, and the dorsal hump can be removed. Spreader grafts can accomplish widening the narrow component of the nose. The hanging columella can be reduced with a columella-plasty. For more information  and many before-and-after examples of closed rhinoplasty, please see the link and the video below

Hanging columella, nose bridge indentation, asymmetry

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You seem to have a slight indentation on your nose bridge, nostril asymmetry, and hanging columella.. Each patient has some degree of nostril asymmetry. This area can improve after the columella is corrected. The indentation will require a graft on the bridge to help make the nose look balanced. You are off toa good start as you know what you want to change about your nose. Next step is to research facial plastic surgeons and schedule consultations. It is imperative to find a facial plastic surgeon who has performed many rhinoplasties before, you want to avoid any revisions in the future- they are harder to correct and more expensive. Feel free to email me your pictures for computer imaging. In good hands, you will get a great result. 

Dr. S

Open or Closed Rhinoplasty

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A rhinoplasty can be done to give you a straighter profile by augmenting the top of your bridge and reducing the fullness above your tip, refining your tip and increasing projection and definition, and lifting the columella. The changes should all be subtle so you achieve a natural, feminine result. It is not important whether the surgery is done open or closed; pick the experienced surgeon, not the technique. I  suggest you consider a chin implant which will also improve facial proportions.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Open or Closed Rhinoplasty? And what should I do to make my nose more attractive?

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Thank you for sharing your pictures.  Based on what I can see, you have a well proportioned nose that could benefit from very minor adjustments, if any at all.  Your dorsal hump could be slightly reduced and your tip could be gently refined. If surgery is what you are looking for, a closed rhinoplasty will not leave any scars externally, however a proper assessment in consultation would be required to determine the best approach and recommendations for your case.

Hope this helps.

Dr. Philip Solomon, Solomon Facial Plastic, Toronto, Canada


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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. You may also benefit from a cephalic rotation of your tip to turn up your tip slightly.  This could be done in either an open or closed approach.  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. 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


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What you want done is completely up to you.Rhinoplasty which typically starts at $5,500 depending on the area you live. To make sure you get the best possible result, the surgeon should perform a detailed exam of the nose and provide a realistic goal that you and your surgeon agree upon. Rhinoplasty are permanent, but with age facial features do change. Find a surgeon and go for a consult. Maybe try and see if the Dr can do photo imaging to show you what he or she can achieve.

Rhinoplasty and small chin implant for better facial balance

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 Rhinoplasty and small chin implant for better facial balance  with a closed approach is best based on more than 35 years experience of rhinoplasty.  The nose should be done very conservatively with slight elevation of the tip, removal of your hanging columella, very conservative hump removal, etc. Make sure you see a very experienced rhinoplasty surgeon for this as you need only minimal  changes and do not want an over done nose!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

No Rhinoplasty

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Your nose looks excellent and goes well with your beautiful face. You risk losing more than gaining by undergoing a rhinoplasty. Do not do it.


Dr. J

My advice

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IMHO your nose does not need a rhinoplasty, at all, it is a nice and well balanced one; do I mean it can't be improved? of course not, any nose can be improved, any, however the better the nose is the more difficult is technically improving a nose without spoiling it... this means... your case is of extremely hight difficulty, need very subtle, well calibrated and fine maneuvers, only safe in masters hands, to:

-lower slightly the alar rims, but only near the tip and not the side of the rim, applying an atypical custom made caudal extension alar batten graft with rim pocket insertion, and of course sutured in place to prevent malpositioning or miscalibration

-a mini-tongue in groove maneuver to sink in, in a minimal grade, the apical (top) fragment of your columella

-mini dorsal shave and careful osteotomies to close the roof

All very subtle, careful, calculated, thought and planned once and again, a real precision work; failing to comply with such milimetrical or halfmilimetrical precision would lead to a mess of nose, so bewawer who you choose for this procedure, has to be a top-notch surgeon with the ability of performing fine calibrations.

Alejandro Nogueira, MD
Spain Plastic Surgeon

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.