Based on my Pre-op nose photo is my wish nose obtainable? (photos)

I'm hoping to reshape the bulbous, overprotected tip. I am 40 years old and concerned that my age may prevent optimal results. I feel that quite a bit of cartilage will need to be removed. Is it too risky to attempt to make such a huge change? I understand that a full examination is required to know what is ultimately achievable and that any answers are purely based on the photo. I would still love to hear your honest opinions.

Doctor Answers 14


Dear royalblueformeto, Age will not have an effect on your overall results. I perform primary rhinoplasty procedures on many patients and often combined with facelifts and browlifts beyond the age of forty often. You will not have the exact nose of Angelina Jolie however the improvements that can be made with rhinoplasty surgery should make you very happy. I would suggest seeking consultation with some experts and have imaging performed to show you a realistic result taking into consideration your nasal anatomy and skin thickness. This will allow you to see these proposed changes and how these will nicely balance your profile and overall facial aesthetics. See some examples of before and after photographs in the link below and a 36 year old patient who wishes she would have done it sooner in the video above. Best regards, Michael V. Elam, M.D.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews

In expert hands, it should be possible to make large improvements to your nose's appearance.

See the "Web reference" link, just below my response. I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands.You have strong tip cartilages. Those cartilages make the tip of the nose droop down, they make the tip protrude strongly forward from the face, and they make the tip look wide and prominent. You also have a small bump on the bridge of your nose. You should understand that the changes I demonstrated in the morph, particularly the complicated work on the tip, require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon. Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them -- so you know whether it's enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. Then, he must show you before and after photos to prove that he can actually accomplish what he draws on the computer.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 41 reviews


Thank you for your question.It is near impossible to replicate somebody elses nose because we all have different anatomys but you would definitely benefit from nasal refinement. I believe you may benefit from a hump reduction and tip rhinoplasty. A dorsal hump can be removed by cutting out the extra cartilage along with filing of the bone to smooth out the bump. A tip rhinoplasty includes trimming the lower lateral cartilages and placing precision sutures to refine the tip and make it look more pleasing. Best of luck in your endeavors.
Sincerely, James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 77 reviews

Based on my Pre-op nose photo is my wish nose obtainable?

A complete exam or at least more photos is needed to answer the question how close you could come. But it appears that you should be able to have a good improvement with proper surgery. Always remember that improvement and not perfection is the goal.

Curtis Perry, MD
Downey Facial Plastic Surgeon
4.8 out of 5 stars 19 reviews

New Nose At 40

From your limited photos it appears that you can achieve significant nasal tip refinement and nasal tip deprojection with rhinoplasty.  Every patient's nasal anatomy is different, so it will be difficult to replicate Angelina Jolie's exact nose for you, but using it as an aesthetic guide will help to guide your surgeon with regards to your final results.  I would suggest in person consultation with a surgeon who specializes in rhinoplasty.  I have provided a link below.  Good Luck!

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 35 reviews

Are My Rhinoplasty Expectations Realistic?

Ag will have no impact on your results. I have frequently combined a rhinoplasty with a facelift in patients a lot older that you did not have this nasal surgery at a younger age. The size and projection of your tip can be reduced but I need to see a full set of pictures as described on my website to answer your question.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Rhinoplasty for the bulbous tip

A full set of facial photographs are required to make a determination about what techniques are required to  make the required changes. It's impossible to give someone a celebrity nose. Digital computer imaging can accomplish giving you an idea of what can be accomplished with your nose on your facial features. The bulbous tip is reduced with suture techniques and a conservative cartilage removal applied to the nasal to cartilages. The tip of the nose can be lifted as well as de-projected with a closed rhinoplasty approach. Look for a surgeon who is dedicated a significant component of their practice to the discipline of rhinoplasty and performs them quite often, since rhinoplasty is a difficult endeavor. For more information, diagrams and many before-and-after results of all bulbous tip reduction, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews


You appear to have an over projected tip and could potentially benefit from refinement of the tip to achieve your goals. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


Thank you for your question.
Your age should not impact the surgical result very much, as long as you're in good health and able to undergo the procedure.  From the image you provided, you do appear to be a good rhinoplasty candidate.  I recommend you consult with several experienced rhinoplasty surgeons in your area who will evaluate your nose from all angles, and let you know if your wish nose is achievable.

Dr. Michael Epstein
MAE Plastic Surgery
Northbrook, IL

Michael A. Epstein, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 49 reviews

Based on my Pre-op nose photo is my wish nose obtainable

The appearance of your nose can be improved with an artistically performed rhinoplasty. What would be the best option and exact procedure would depend on an examination and discussion about desired outcome. 
Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you exactly what to do and what the result will be based on two dimensional photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon with extensive rhinoplasty experience certified by the American Board of Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. Additional information about the procedure will help you decide if it is a procedure that you want to pursue. 
Robert Singer, MD FACS 
La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 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.