I have a big, wide shapeless nose. What are my options to make it more narrow? And is a closed/open rhinoplasty best? (photos)

Thank you very much for the questions.

The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.

In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping.
With this procedure you get a delicate nose, better harmonize with your other facial features.

Kind regards

DR. Emmanuel Mallol.-

Thank you for your question. It is important to consider the shape and appearance of your nose within the context of your overall facial features, facial shape and ethnic background. For example, sometimes making a simple change to the chin can make the nose look to be in a more appropriate proportion. As to the type of rhinoplasty, a closed procedure occurs when the incisions are hidden inside of the nose and the surgery is done with small instruments form these incision sites. An open procedure is where incisions are made around the nose and often, across the columella (the strip of tissue that separates the two nostrils). An open procedure is a more predictable and precise approach that allows for more access to the underlying structure of the nose. Please consult with a board certified facial plastic surgeon.

Best wishes,

Aesthetically, you would certainly benefit from a rhinoplasty. Interestingly, you have a moderate sized hump that can be seen from the lateral view point which points to a North African, Middle Eastern heritage. In addition to removing this hump, your nasal tip needs to be refined by strategically removing and suturing the alar cartilages via an open technique. Your skin will need to be defatted in order to thin that out so that some of the delicate inner work  can shine through the skin to maximize your results. Your nasal tip needs to be rotated somewhat upwards as well as projected. Finally,  I would narrow your nasal base which will complete your picture and prevent the flaring of your nostrils especially when you smile. Of course, all of this would be discussed in detail with your surgeon and having him or her present to you a computer image of what they propose will help you visualize the end result and serve as a communication  tool.

The toughest thing to deal with in your nose is the thickness of the skin. We can thin it out some during surgery, but it will never become really thin. Having said that, you can certainly make some nice improvements in your nose that look natural. The bridge is a bit low and a graft can give it more definition. The cartilage can be thinned and better supported to create a more defined tip, and the nostrils can be narrowed some. Be sure to find a rhinoplasty specialist for consultation.

You have beautiful features! Refining the nose will really bring out the beauty of your eyes. I prefer the closed technique for patients with wide noses. While there would be an incision in the crease between the nose and cheek to help narrow the base of the nose, it would not be necessary to place an extra incision along the tissue separating the nostrils. One of the main determinants for a doctor recommending open vs closed for someone like you probably reflects how they were trained. Some doctors open everyone. I prefer the closed technique for most and reserve the open approach for the very crooked or difficult revision case.