I have a droopy nose tip. Am I a candidate for closed rhinoplasty? (Photo)

Question

I need to lift the tip of my nose. Am i candidate for closed rhinoplasty? i tend to scar and am concerned how this will look if done with open. how can i find a doctor that is qualified without spending hundreds in consultation fees?

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.As far as I can see from your photos your nose has; droopy tip, hump on the bridge and hanging columella. For get rid of these things you may need; alar base reduction and external graft. So this is the reasons that why you should not get closed rhinoplasty. With the closed rhinoplasty you do not have any scar but you would not achieve your wishes. You will only get rid of the hump. It would be more convenient to decide with face-to-face consultation. Best Regards!

Eric M. Joseph, MD · Answer

In our practice, we perform nearly all of our rhinoplasties with a columella incision. In our experience, the open approach allows for better visualization of the nasal tip structures that may need lifting and projection. The best advice is to find a few surgeons who has before and after photos that you find pleasing. I think it's helpful if your surgeon or first computer Imaging as well. Once you find somebody that produces favorable rhinoplasty outcomes, you can go on Several consultations and learn what might be best for you moving forward.
Based on your photos, the lower 1/3 of your nose appears wide. You also have an underprojected tip, a large dorsal hump, and an acute nose lip angle. Well performed rhinoplasty surgery with either an open or closed approach maybe considered for achieving a Less distracting and more feminine nasal appearance. Hope this helps! Dr Joseph

Nima Shemirani, MD · Answer

Hi @Mclaud! Thank you for sending your photos. I recommend seeing an expert rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination. A rhinoplasty in my opinion is one of the most difficult procedures to perform. I utilize piezosurgery in my practice. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. Best of luck, Dr. Nima!

Yannis Alexandrides, MD, FACS · Answer

It is possible to have Closed Septorhinoplasty and elevate the tip without the need of an open technique which is more invasive and has more visible scarring.

Thomas Trevisani, MD · Answer

In person exam is essential. Based on limited photos - it appears that you would benefit from Rhinoplasty preferably performed through a closed technique. In the right hands you can expect a more feminine and refined nose. I suggest that you seek an experienced Board Certified PS with a wide gallery of before+after photos

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. You are an excellent candidate for rhinoplasty. I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. The incision in open rhinoplasty heals almost always invisibly. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Steven M. Denenberg, MD · Answer

A rhinoplasty surgeon would say that your tip is not droopy -- your tip sits nice and high -- but it's the size and shape of the hump along the bridge that *makes* the tip look droopy. The goal would be to lower the hump, making the tip look better. You'd probably see that great with a good morph. Then, the frontal views seem to indicate that the tip of your nose is wide as well, so maybe that would be addressed. And finally, it wouldn't be wise for the surgeon to *only* remove the hump, because in a nose like yours, typically the tip cartilages don't have superb support, and they need to be supported to maintain a good shape.
How *much* to lower the bridge, or narrow the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon.  And it also discusses how to take photos that are best for online evaluations.

Ronald J. Edelson, MD · Answer

You are a good candidate for rhinoplasty open or closed.  Although I do mine closed most surgeons only know how to do open because closed rhinoplasty isn’t taught much. However I would concentrate on finding the best surgeon whether it’s open or closed. Using the right surgeon is more important

Douglas L. Vander Woude, MD · Answer

Hello.  I think you could benefit from a rhinoplasty.  You have some under-projection of your tip that would require cartilage grafts.  Make sure to obtain a couple of opinions from qualified surgeons with experience in these procedures.

Robert Ciardullo, MD · Answer

Closed rhinoplasty. there are not many surgeons who specialize in closed rhinoplasty. Closed rhinoplasty happens to be all that I do, and have done about 5000 of them. You would be a good candidate for closed rhinoplasty. But your tip does not really droop. It appears to droop because you have a dorsal hump which curves outward and makes the tip look like it’s pointing downward particularly when you smile. However if you look at the angle that your tip makes with your upper lip when you are not smiling, It is evident that your nose actually points up quite a bit. You also do you have a hanging columella. Reducing the dorsal hump will make the inherent upward angulation of your tip more obvious as well elevating the hanging columella. print the photo of your side profile that you show without a smile. Then take a black pen and remove the dorsal hump and the bottom of the hanging columella. you will see that the tip actually is pointing up quite a bit and does not droop. It is the dorsal hump which creates the illusion of a downward drooping of the tip.