Side profile improvement options? How to balance features? (Photo)

Question

I'd love advice for how to balance my features. I have small features, with the exception of my nose, and a round face. I need an experts opinion on what procedure I could have done. I've thought about lip and/or chin fillers extensively but just recently thought of a septo-rhinoplasty as an option. I'm getting married and would love to be happy with my side profile before the wedding! Any advice is welcome.

P. Daniel Ward, MD · Answer

Dear Nikki3009,Thank you for your question. I think there are some subtle things that could be performed to dramatically enhance your side profile. First, you have a slight dorsal hump on the nose, which makes the nose look like it is pointing downwards. Addressing the nose would significantly help. In addition, your chin is a little bit on the small side, an augmentation would help improve that aspect of the face. Finally, if you were concerned about the roundness of the face, you could consider having Buccal Fat Removal performed in addition to possible lower cheek liposuction to help give a more contoured and heart shaped face. Adding some volume to the cheeks with filler would also help improve the facial contour on frontal view.Please let us know if you have any other questions or concerns!Sincerely,Dr. P Daniel Ward

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a rhinoplasty with dorsal hump reduction and a nasal tip deprojection.  A chin implant can be performed at the same time for
improved jaw line contour and improved facial balance.  I always use a medpor implant with screw
fixation, which stays in place over time.  A silicone chin implant has a
high rate of malrotation over time.  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

Steven M. Denenberg, MD · Answer

Click on the "Learn more" link, just below my response, or go here:
FacialSurgery.com/RealSelf/RealSelf_Nikki3009.html
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.I lowered the little bump on your bridge, and elevated the tip. Then I brought the entire nose back closer to your face. You can see the changes best in the animation.Your chin looks fine -- leave it alone. If you have a rhinoplasty, it should be to make enough of a change to make having the operation worthwhile, like what I proposed in the morph. Don't do it to only make a teeny tiny tweak.
You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon. You should only have surgery if you are able to make yourself very confident in your surgeon's skills. Read that page very carefully. Most plastic surgeons are quite poor at this operation, and I believe my advice will go a long way toward keeping you safe.
I'd love to hear what you think of the morph. Did it seem to address your main concerns?
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. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who understands all of the issues I mentioned, and how they fit together, and who can actually accomplish them in surgery.

Adam Bryce Weinfeld, MD · Answer

Congratulations on your upcoming wedding.  Based on your profile photo, it seems you would be a good candidate for cosmetic rhinoplasty.  I suggest you schedule a consultation with a plastic surgeon for further evaluation and suggestions.  Be sure to allow adequate time to heal after surgery prior to your wedding. Best of luck.

Barry L. Eppley, MD, DMD · Answer

You will need computer imaging to help you determine what type of facial changes may be beneficial to your profile. You need to look at a rhinioplasty and chin augmentation separately and then as a combined procedure. The images will make that decision very clear to you.

Stephen Weber MD, FACS · Answer

You do appear to be a good candidate for rhinoplasty. Adding some filler to your lips and chin (or a very small chin implant) would also enhance your profile and add some more balance. Best.

Robert Singer, MD · Answer

The ideal aesthetic result should be individualized to achieve harmony with your other facial features and improve the areas that concern you. Nasal cosmetic surgery and a chin implant are frequently performed together in the appropriate patient. Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you exactly what to do 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. The extent and length of the procedure, cost, and the specific operative steps to achieve an ideal cosmetic result vary from patient to patient and would depend on the findings at your consultation examination. 
 
 Robert Singer, M.D., FACS
 
 La Jolla, California

William Portuese, MD · Answer

The side profile photograph demonstrates an overly projecting nose and an under projecting chin. Consider a rhinoplasty procedure which can decrease the overall projection of the nose, shave down the dorsal hump, refine the nasal tip and narrow the bridge line. A septoplasty is performed in the back of the nose to improve airflow, it is only performed for medical necessity. Consider placement of a chin implant to augment the weak mandible forward, to help with the side profile, especially with respect to the nose. Chin implants are manufactured in a large assortment of sizes and shapes which is best determined at  the time of the consultation and examination. Make sure you perform these surgeries at least several months before your wedding to allow full healing. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience. For many examples of  rhinoplasty performed in conjunction with a chin implant, please see the link and the video below

Benjamin C. Paul, MD · Answer

I would recommen a subtle rhinoplasty to file down the bump and improve the feminity of the nose. I would recommend a silicone chin implant for an improvement in your profile. This would help reduce the roundness of the face that goes along with having a weak chin. Lastly, I would try some restylane in the lips for a little more volume.  Although this sounds like a lot, it would actually be a beautiful and subtle enhancement that you would love.  Congrats in advance on your wedding.

David Alessi, MD - Account Suspended · Answer

Your profile would be improve with a rhinoplasty to reduce the size of the nose.  An in-office consultations or a more complete set of pictures would be needed to assess fully.  However, a closed rhinoplasty is possible.  Also, brides to be often do a little fillers to the cheeks and lips.  Best wishes.

Side profile improvement options? How to balance features? (Photo)

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