Your nose is crooked and most likely you have a deviated septum. High nostrils can be lowered either with cartilage grafting at the time of surgery or, perhaps with fillers, temporary or permanent. The bump should be taken down. The answer to your question is that the objections you have are valid and those problems can be improved. “Is it worth it?” That is up to you. You have to decide whether the cost, the time away from work, etc., is commensurate with the improvement that can be obtained. Most people find that rhinoplasty and associated procedures such as septoplasty and turbinate reduction to be valuable and “worth it.” Generally it is a once-in-a-lifetime procedure and it improves breathing for many people, as well as giving them satisfaction with respect to their appearance.
To make the best decision there are certain things you need to do.
You want to do your homework before consultation. Prepare well for your consultation. When you search, look for rhinoplasty super-specialists. These are surgeons whose practice is the majority or entirely devoted to rhinoplasty, septoplasty, and related procedures. This would include both primary and revision rhinoplasty surgery. Why not have the most specialized talent in your service? Consider how much experience the surgeon has doing the procedure you are considering. We all get better at what we do with time and so those surgeons who have a long run of experience are the ones who have learned the most from experience. Residency and fellowship are where the learning begins, but for all of us, time and experience is where the education continues.
Part of your preparation for consultation should be preparing a list of questions beforehand. Bring a notepad or ipad or laptop with you and take notes as the surgeon answers the question you are asking. You should spend more time with the surgeon than with the office administrative staff, because you need to get a sense of whether you are comfortable with the doctor. You should not feel rushed that you are on a consultation conveyer belt. If the presentation by the office staff seems a bit to “salesie” that is a bit of a yellow or red light. Take a friend or relative along since two heads are better than one in gaining information and understanding. In the end, the purpose of the consultation is for you to be educated and be comfortable, not to be “ sold”. Ask yourself two key questions: “Is this surgeon teaching me or selling?” And secondly, “Can I put my life and my face into this particular surgeon’s hands? Can I trust him/her?”
There are excellent books out there that you can read and use to study up. It is worth the homework time you put in up front so that you make the right decision with respect to choosing a surgeon who has the talent, experience, and degree of super-specialization that you certainly want to have.
When you visit doctor’s websites, the most important feature on the site is the before and after gallery. If there are just a few examples of rhinoplasty or revision rhinoplasty, you wonder how much experience the surgeon has performing such surgeries. There need to be dozens and dozens of examples. The more examples there are, the more likely you will see one or more that demonstrate situations similar to yours. Look closely at the photos for natural results. That is what you want. Nobody wants to carry a sign saying “I have had a rhinoplasty.”
Reviews on review sites, particularly RealSelf are very important and should be carefully digested. The larger the number of reviews the most accurate the picture of the practice and particularly the doctor. A consensus is generally correct.
A consultation without computer imaging is, in my opinion, of much less value. Why shouldn’t you see the predicted result of the procedure the doctor is proposing? At consultation, photos are taken of you and loaded into a computer system that morphs your present appearance into the anticipated “after” based on the nasal surgeons input. Imaging is an incomparable learning tool because it provides a forum for doctor and patient agreement on what would satisfy the patient and what is, in the doctor’s opinion, achievable. After all, cosmetic surgery is 100% visual. It is about appearance, so without a visual evidence of what is planned, how can you make a decision as to whether or not you might be satisfied. Talking about it is worthless. To anticipate a successful outcome, there must be a meeting of the minds between surgeon and patient.
Robert Kotler, MD, FACS
Over 4,500 nasal procedures performed
Dear charlesfoy1998, Have you had any previous surgery to your nose would be the first question I would ask. It appears that possibly your nose was shortened and possibly alar reduction performed? With that said your nose can be improved by reducing the dorsal hump, addressing the hanging columella, and asymmetries. A consultation aided with imaging can show you these proposed changes and you can then decide if the proposed changes would be worth it to you. Best regards, Michael V. Elam, M.D.
One issue is the short nose as noted by the large nasolabial angle. It is difficult to lengthen such a nose and get a great result.Treating the bump, crookedness and the midsligned columella are more routine.If it bothers you, fix it.I don't think its worth the money, risk or time.Its not an ugly nose.
Rhinoplasty can be done to remove your slight hump, correct the asymmetry, lift the hanging columella, and possibly lengthen your nose which appears to be short in these pictures. Have you had any previous nasal surgery? Consult with a rhinoplasty specialist to discuss your options so you can establish reasonable goals and decide if it is worth it.
It is very important to have realistic expectations upon what can and cannot be accomplished with a rhinoplasty procedure. From the very limited photographs, the nose can be straightened with osteotomies and spreader graft placement on the concave side. The nostrils do not appear to be retracted upwards, however there is a hanging columella which needs to be reduced to make the nostrils more in proportion to the base of the nose. The dorsal hump is composed of both bone and cartilage which needs to be shaved down. Digital computer imaging performed at the office setting would be helpful to understand what can and cannot be accomplished with your nose. For more information in many rhinoplasty before and after results, please see the link and the video below