Pixie Nose Shape Require a Rhinoplasty Specialist?

Some people think my nose is cute because it’s pixie or elf-like. When I was younger boys made fun of me, calling me stuck up because of my nose shape. When I look at my friends and celebs no one has a nose like mine. I don’t feel sexy and I’m obviously self conscious about it. I’m considering finding a plastic surgeon for a nose job. Does anyone know if some surgeons specialize by type of nose job, or is a nose job just a nose job?

Doctor Answers 46

Short or Pixie Nose

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From your description, it appears that you have a small and up-turned nose. This is consistent with a nose that is short in comparison to the rest of facial features.

You can have a good result if your surgeon is committed and patient. This is the type of operation that requires expertise and experience. Please make sure that your plastic surgeon is passionate about getting the best possible results and listens to your desires carefully and answers all your concerns.

Hope this was helpful.

Dr. Sajjadian

Pixie Nose: Is Beauty in the Eye of the Beholder?

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Your nose, the pixie nose, was once the most sought-after nose to have.  If you look at pictures of models in the 1960's, many have pixie noses.  Indeed, the rhinoplasties performed then, with the scooped bridge and turned-up tip, were designed to emulate the pixie nose.  Today, we think of a higher bridge and less-upturned tip as more esthetically ideal, but the pixie nose look is not dead.  Many of my patients from South America still want that look since there it is still popular in some areas.  What matters most is whether your pixie nose matches your face.  A shorter, upturned nose may work beautifully with a small face, but less well in a face with larger cheek bones or a stronger jaw line.  Obviously your nose bothers you, so probably a consultation with photo-imaging will help you decide if changing it will make you look better.

Improving a pixie nose typically calls for raising the bridge and lengthening the tip by counter-rotating it.  Both these maneuvers are challenging, with nasal lengthening one of the most difficult maneuvers in rhinoplasty.  I would recommend you select a surgeon with ample experience in this particular technique.  Ask to see before and afters of patients with noses like yours.  Assess whether he is an occasional rhinopalsty surgeon, or an experienced one.  Talk to his other rhinoplasty patients.  Trust your instincts on this and you are sure to have a good outcome.

Minas Constantinides, MD
Austin Facial Plastic Surgeon

You need to see an experienced Rhinoplasty surgeon for pixie nose

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I would be curious to see what your nose looks like. I suspect you may have had an injury to your septum where it was fractured causing a short and over rotated nose. As some of the other answers suggest, a rhinoplasty is the most difficult and rewarding facial plastic surgical technique. The best chance of a great result is with the first surgery, so chose your surgeon carefully. After you have interviewed several you will figure out who is qualified and experienced. Good luck.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 63 reviews

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Rhinoplasty or nose surgery requires someone who has performed many of those procedures

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The most difficult plastic surgery procedure is a rhinoplasty. The reason for this is that the nose is three dimensional and requires correction of the underlying structures, soft tissue, cartilage and bone. The interrelationships of those three tissues can alter the shape and final appearance after rhinoplasty surgery.

My recommendation would be to go to a surgeon who has done a large number of those procedures since they have more experience. A lot of general plastic surgeons only do a few of them a year and have not achieved the greater level of expertise. Most facial plastic surgeons have done a large number of those procedures. However, some general plastic surgeons also have done that additional training and have experience there as well. The most important question to ask is how many they do a year and what is their revision rate. If they say their revision rate is zero, then I would go elsewhere. Also, the best rhinoplasty surgeons are the ones who can do a revision themselves and do not refer those patients out.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Choose a Surgeon Who Specializes in Rhinoplasty

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Choosing a qualified surgeon is the most important decision you can make when deciding to under go nasal surgery because rhinoplasty is considered the most diffcult procedure in cosmetic surgery. Every rhinoplasty is unique -- a nose job is never "just a nose job."

Tips on Choosing a Rhinoplasty Specialist:

  • First and foremost, choose an surgeon who specializes in nasal surgery. Your surgeon should be experienced at correcting both cosmetic problems and functional problems (such as a deviated septum).
  • Your surgeon should be Board Certified in either Otolaryngology (ENT) or Plastic & Reconstructive Surgery. It is important, however, to know that not all ENTs or Plastic Surgeons routinely perform rhinoplasty. It is important to find one who does. Several resources that can help you find a surgeon include the AAFPRS (http://aafprs.org) and ASAPS (http://surgery.org).
  • View the Surgeon's Rhinoplasty Before & After Results. Most rhinoplasty surgeons maintain a portfolio of examples of their results that compare before and after photos, and many qualified rhinoplasty surgeons have a "Results Gallery" on their websites. You can tell a lot about your potential results by looking at their previous work.
  • Ask to See Simulated Results. Your rhinoplasty surgeon should analyze your pre-operative photographs with you and be able to show you graphically their intended results.

Find a plastic surgeon with appropriate training in rhinoplasty.

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A pixie nose deformity is characterized by shortness of the nose and an upward turned nasal tip. In some situations, this may not represent a deformity because this type of nose may fit nicely with the surrounding facial structures. In other cases, this deformity may require surgical correction.
There aren’t rhinoplasty specialist who exclusively work with pixie nose deformities. Surgical correction of this problem requires a surgeon who has appropriate training and experience in rhinoplasty surgery. It’s therefore important to consult a specialist who has these credentials.

Rhinoplasty' for a 'pixie' nose

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A smallish nose with upturned tip and a gently sloping dorsal aesthetic line is desirable - I'm not sure if your nose looks like this - but these are features of an attractive female nose. Without photos its impossible to make specific comments. Seek out a plastic surgeon in your area with rhinoplasty experience and get an informed opinion on your surgical options.

experienced rhinoplasty surgeon

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 An experienced rhinoplasty surgeon who was performed thousands of nasal surgeries should be able to deal with your unique shape nose with confidence. Look for surgeon who has  dedicated  a large part of their practice to the discipline of rhinoplasty, for best results. For many examples of rhinoplasty, please see the link below

Difficult Rhinoplasty

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A small or "pixie" nose can certainly be reshaped, but a nose job isn't just a nose job -- particularly when the goal is to make the nose bigger. This type of rhinoplasty (sometimes called "augmentation rhinoplasty") can be quite complex and generally involves adding tissue.  Most often, this is from your septum, ear, or sometimes rib cartilage. I recommend seeing at least two or three different plastic surgeons. This will help you refine what you want, allow you to hear different philosophies, and select both an aesthetic and a doctor that you like. In addition, computer imaging can be a valuable tool in your discussions and will help you define what you do and do not like. Best of luck going forward!

Treating upturned, pixie nose

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Rhinoplasty surgeons don't usually sub specialize in only treating the upturned nose. If you are interested in improving this consulting with a few experienced rhinoplasty surgeons would be recommended.

Counter-rotating the nasal tip is challenging but certainly feasible. I find that this is less difficult in patients like yourself who haven't had prior surgery.

There is certainly a range of normal tip rotation (how upturned it is). Computer morphing of your nose would allow for a better discussion of your goals and how attainable they are given your anatomy and other facial features.

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.