Did my surgeon leave my nose too large and pointy? (Photo)

Question

I had expressed to my surgeon that I wanted a smaller looking nose and that I wanted the tip reduced, the dorsal hump to be reduced and to fix my deviated septum. I expressed these concerns to my surgeon but I feel like my results weren’t achieved with what I was asking, he did straighten out my bridge and fixed my deviated septum but he didn’t make my tip smaller, before I had asked him and he insisted on using my existing anatomy and now I feel my nose looks big and pointy.

Eric M. Joseph, MD · Answer

I agree that you appear to have an over projected nasal profile appearance. Computer imaging is a modality to establish goals before rhinoplasty surgery. Based on your photos, do you knows appears to be a bit swollen. If you have continued the satisfaction by 6 to 8 months after surgery, revision rhinoplasty may be considered. I hope this helps. Sincerely, Dr. Joseph

Andrew Miller, MD · Answer

Based on your photos, your nose is still a bit long. There are limits as to how far a deprojection can be done, but you should be able to make your nose smaller still. Be sure to see a rhinoplasty expert that can do computer imaging at the same time.

Steven M. Denenberg, MD · Answer

Projection refers to how far forward the tip of the nose comes away from the face. Unfortunately, "de-projecting" a nose, that is, bringing the tip back closer to the face, is a task that most plastic surgeons don't know how to accomplish, especially in a nose that needs a lot of it.

When was your surgery? Early swelling can make the tip be strong in its projection, but swelling will usually only hold the tip out by about one millimeter, and your nose requires much more deprojection than that.

The woman whose before and after photos I posted with this answer had a very projecting nose.

It looks as though you will probably require a revision in order to get your nose closer to where you want it. 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. 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.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.

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