I've had three surgeries so far, and the result of a delicate nose continues to elude me. From a profile angle, I think my nose looks overprojected and too big for my face - like it dominates my face, and that my columella hangs too low. From a frontal view, I believe the high tip affects symmetry and brings attention to my nose rather than my eyes. Also, the area above the tip and lower dorsum could have more definition. Are my perceptions correct? Please be elaborative in your response.
To Me It Looks As Though my Nose is Overprojected and I Have a Hanging Columella. Is This the Case? (photo)
Doctor Answers 5
Over Projected Tip with Hanging Columella
In addition to a slight reduction of your tip projection I suggest that you augment the radix (the top of your bridge between your eyes). This will improve the proportions of your nose from the profile view. There is some fullness of the columella but is not technically a hanging columella. The fullness immediately above the tip should be slightly reduced.
Nose out of proportion
I think one of the main issues is that your bridge is too low. Your nose appears to start around the level of your lower eyelid. It should start higher, toward the upper eyelid crease. This would give your nose a more elegant look. The nose is essentially "bottom heavy". I disagree with deprejectiong your nose. It is not excessively over-projected. De-projecting the tip would probably end up causing new problems like nostril flare and loss of tip definition. I do not see a hanging columella. You could probably use a bit more "double break" of the columella on profile. You should absolutely go see a rhinoplasty surgeon that does computer imaging so you can have some idea what these maneuvers might look like on you. Finally, I cannot tell on the photos well, but is your chin under-projected? This can give the nose an over-projected look. It's all about balance. Good luck!
Your nose may have reached its capacity for reduction
The nose can only be reduced to a limited degree, mainly limited by how much the skin can contract to drape tightly onto the internal structure of the nose. If you have had 3 surgeries, I imagine that you have already had some reduction attempted. If the skin cannot shrink much further and an attempt is made to reduce the projection of your tip further, the skin may stay puffy and create fullness above your tip (called a polybeak). This can also make the lower bridge look wider. It is possible you have a bit of this already though it is hard to tell just from photos. Furthermore, if you reduce the projection of the tip, the bridge will be too high relative to the tip, and the nose will start to look rounded or hooked from the profile.
I do not think your columella is too low. I would not recommend augmenting your dorsum, particularly at the lower aspect as this will result in a graeter heaviness to the lower half of your nose.
Unfortunately, I do not think it is possible for you to have a truly delicate nose given the anatomical and skin related limitations you appear to have. Though your nose may look a bit larger than you idealize, it is smooth and reasonably proportioned. If you pursue changes that are not readily attained with further surgery, you may lose those positive features and end up being worse off.
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Nose is Overprojected and I Have a Hanging Columella. Is This the Case?
Aesthetically speaking, from the photos provided, the nasal tip is slightly over-projected and a bit wide. The Columella is not hanging however the chin is quite weak making the nose appear larger and longer than it truly is. A Chin Implant along with a Closed Rhinoplasty would address these issues. Hope this helps.
To Me It Looks As Though my Nose is Overprojected and I Have a Hanging Columella. Is This the Case?
The nasolabial angle is ok and as such the tip is not too high. Neither is there columellar ptosis or need for correction. I would agree that the tip seems to have too much projection. I would deproject the tip and augment the dorsum a bit as well. Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA