Is my nose going to be more complex to work on? (photo)

Question

I have a very distinctive nose. It’s a hugeeeee insecurity of mine. To the point I wear a hat everyday so people don’t focus on it. It’s really affecting my day to day love. When I smile it looks huge. Is my type of nose a difficult rhinoplasty? I’m just worried it’s going to be crazy expensive because I’ll most likely need a piece of rib for the tip of my nose.

Lexie Wang, MD · Answer

Your nose does not look particularly complicated that it would require any additional cartilage and/or cost and/or effort to achieve a reasonable result. Of course, this is knowing nothing else about you and not having a physical exam. The main thing I would caution you of is that if you are that self-conscious about your nose, you need to be aware of the healing afterward and that your nose ewill take a while to show its final result and may not be perfect, and whether that is something that you can mentally go through.

Donald Groves, MD · Answer

Hello and thank you for your question and the pictures. You actually have a difficult problem. To properly address your nose and improve your facial balance, you would need a rhinoplasty with nasal tip deprojection to improve the overall harmony of your different facial features.

This truly a surgery of millimeters- and tip deprojection is one of the most technically challenging surgical techniques! So yes, it will be more complex, but you would have an amazing result you'd be excited to show off! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading rhinoplasty experts (who performs 1,000+ nosejobs annually).

I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

John Michael Thomassen, MD · Answer

You do not need rib cartilage.  A tip rhinoplasty would be sufficient to  reshape the tip cartilages to correct the rounded lower lateral cartilages and their separation.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
If you have had a previous operation, you may need to use extra cartilage from the ribs and ear. I recommend a rhinoplasty operation for a more feminine and elegant look.
It would be better face to face consultation.
Best Regards!

Adam D. Stein, MD · Answer

Yes, you are a candidate for a rhinoplasty. Although all rhinoplasties are complex and challenging because it is a difficult procedure, there is nothing about your nose in particular that would make performing a rhinoplasty any more difficult than another case. I would recommend getting a consultation with a rhinoplasty specialist (someone who is board-certified in facial plastic surgery) to evaluate.

Kyle Kimura, MD · Answer

Thank you so much for your questions and providing photos!
I actually think based on your photos that you would be a great candidate for a rhinoplasty. Your nasal skin looks fairly thin which is likely why you can see the ridges/edges of the cartilage underneath the surface. I personally believe each rinoplasty comes with its own unique challenges and difficulties. I think yours would be the same, with its own challenges, but I absolutely think you could achieve a great result with surgery. 
I also think it is unlikely that you would need rib cartilage. I will often use rib cartilage in the case of significant trauma or previous nasal surgery, but in your cause I think we could avoid this. I would however plan on potentially getting fascia (thin layer of tissue on top of the muscle) from behind your ear to help with the thin skin. 
I think your best bet is to schedule a consultation with a plastic surgeon that is well versed in rhinoplasty and someone you ultimately feel comfortable with to move forward with surgery. I think you have the opportunity to get a real home run result.
Hope this helps and best of luck!Kyle Kimura, MD

Anna Bakeman, MD · Answer

You have prominent lower lateral cartilage at the tip of your nose, but the rest of your nasal structure looks excellent. During a consultation, you’d want to discuss your specific cosmetic goals with your surgeon. In your case, surgery would likely involve reshaping the nasal tip using small cartilage grafts to create a more refined contour.
If you haven’t had prior nasal surgery, it’s very likely that the necessary cartilage could be harvested from your nasal septum rather than requiring rib cartilage.

Gianfranco Frojo, MD · Answer

You have large lower lateral cartilages. This can be easily addressed with specific rhinoplasty maneuvers. I do not believe that you would require a rib graft based on the photos provided.

Andrew Miller, MD · Answer

Most likely you will not need a piece of rib for your nasal tip. A well performed can decrease the wideness of your nose nicely and keep it looking natural. I will be better supported so it doesn't droop or widen as much when you smile. Be sure to see an experienced rhinoplasty surgeon for consultation.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos.  It appears your upper nose and your dorsum has excellent shape and contour. Your lower nose/nasal tip appears to have over developed, rounded and over projecting cartilage. This cartilage can be reshaped with sutures and de-projected to refine your tip and to bring it into better balance with the remaining part of your nose. This is not an overly complex rhinoplasty to perform. Some modification of the nasal tip is done in almost all rhinoplasty. This is not an overly complex rhinoplasty to perform. Have a detailed consultation with your plastic surgeon to understand what could be accomplished for you. Best wishes.

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