Why don't I often see drastic changes like this in Rhinoplasty 'before and after's? (photo)

Is it possible to go from having a wide, flared, obtuse alar base with a bulbous tip to thin, more projected, acute looking features? Is this not often seen because most patients desire more subtle changes or are there great difficulties/limitations in accomplishing this? Is this type of transition, for the sake of someone desiring to change their identity with no regard for subtlety, feasible? Would you elucidate the challenges involved in achieving implementation and how they can be managed?

Doctor Answers 5


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NAK91, I can see you put a lot of effort into your attachment but unfortunately it is not too helpful in answering your question as a photo does not allow me to feel the thickness of your skin or the strength of your cartilage or analyze your face in terms of your 3D picture and your ethnicity. So see an experienced surgeon that does "only faces" and get evaluated to get a better answer. See video. Good luck!

Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 52 reviews

Can it be done

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Large changes to a nose are theoretically possible. The likely hood of the changes looking good and appropriate depend on the patients tissues and the skill of the surgeon. Not all patients can have the changes they want from an anatomy standpoint alone. Not all surgeons produce the same results ie some are better rhinoplasty surgeons than others. See a board certified plastic surgeon who has experience in rhinoplasty. The more complicated the surgery, the more likely a revision is possible. Good luck.

Drastic rhinoplasty changes

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The amount of changes that are performed during the rhinoplasty procedure are measured in millimeters. Usually the most dramatic change after a rhinoplasty  is to shave the dorsal hump down. An alar plasty procedure usually accomplishes removal of a few millimeters of skin at the base of the nostrils to narrow  them. It's also important to have very realistic expectations about what can and cannot be accomplished.


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Hello and thank you for your question. It is possible to decrease the alar base width with this technique.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon


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Many such changes to the nose as you are proposing but what the tissues will allow. Thicker nasal skin often prevents finger tip definition from being seen. Major tip projection increases often require a rib graft which patients may not want to undergo. Such transformations are a lot easier on paper/drawings than what can be achieved on actual patients.

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.