Rhinoplasty for bulbous, upturned nose

Question

My nose has always bothered me. I think it looks deformed and doesn't fit my face. I'm interested in a surgical rhino (closed if possible) to address the following: -bulbous, upturned tip -hanging columella -wide nostrils with lots of show -nasal flare when smiling widely (weirdly asymmetrical) I don't have a specific ideal nose picked out. I just want it to be more refined (without being pinched looking) and fit my face better. Thanks for your input.

Caner Kacmaz, MD · Answer

You are a Great Candidate for Rhinoplasty .
Ultrasonic Rhinoplasty device Piezo®:

In traditional Rhinoplasty, surgical instruments known as rasps and osteotomies (hammer and chisel) are used to reshape the nasal bones by removing the hump and/or narrowing the nasal bone width. These tools are relatively imprecise and their use can lead to contour irregularities, etc. if not used in the proper manner. Recently, a technology that uses sound waves has been developed to contour nasal bones in a precise and far less traumatic way when compared to traditional techniques. Ultrasonic, or Piezo, Rhinoplasty is now the most advanced technology available for minimally traumatic nasal bone reshaping and hump removal during Rhinoplasty. There will be hardly any bruising and swelling which will make the recovery period a lot easier for the patient.

Andrew Miller, MD · Answer

From the photos, it appears that you are a good candidate for rhinoplasty. The tip can be made smaller to better fit your bridge. It is very important to see a rhinoplasty specialist where you can see lots of before and after photos. It's not an easy procedure and experience is key here.

Richard A. Bartlett, MD · Answer

Dear daduke, 
Thank you for your question. Based on your photographs, it appears that most of your results can be accomplished. Although it is hard to tell from photos alone, it would most likely need to be an open procedure. However, an in person assessment with a Board Certified Operating Surgeon must be completed in order to determine for sure. I suggest doing research in surgeons who specialize in this operation and scheduling a consultation. Best of luck to you.

Ronald Schuster, MD · Answer

I agree with your observations. The tip of your nose is over-powering the rest of your face. The dorsum looks like it might not need much if anything. Reducing the tip is fairly routine for experienced rhinoplasty surgeons. I would want to do it using an open approach in order to see things directly and be more precise. sounds like it's time for you to get some real consultations. You should get a great result. Good luck.

Philip S. Schoenfeld, MD, FACS · Answer

You have a uniquely appearing nose.   The changes that you are seeking can certainly be accomplished.  Your tip is not particularly bulbous, but it is over rotated and raising the medial crura and downward rotation of the nasal tip will certainly help to achieve the appearance you  are looking for.  A consultation with an experienced rhinoplasty surgeon who will use computer imaging is also a very good way to help demonstrate the changes that you would like to see to the appearance of your nose.

Zoran Potparic, MD · Answer

Based on these photos, your tip seem to be the only one that needs shaping. It is of utmost importance to consult  a true expert in rhinoplasty (board certified plastic or ENT surgeon) since this type of rhinoplasty needs great expertise. Good luck.

Tanveer Janjua, MD · Answer

Yes you are a good candidate to reduce the nose but only in tip and nostril area. Your nasal bones are fine. 
You can have the lower half of the nose (tip and nostrils) addressed without breaking the nasal bones. Tip-plasty can address the bulbous tip either through closed or open approach to make it narrow and refined.
Alarplasty is a very fine and quick procedure that can narrow the nostrils and reduce the flare to soften the appearance. It has other names as well like ‘Weir Excisions’ or ‘Nostril Reduction’. However, it is important to note that asymmetry of nostrils is common and cannot be corrected with alarplasty.
 Both of these can be done under local anethesia.
Watch the video link below.
Regards
Dr. J

Daniel Barrett, MD · Answer

Dear daduke,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would get great result after rhinoplasty. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Regan Thomas, MD · Answer

Based on your photos you appear to be a good candidate for rhinoplasty.  You will benefit from narrowing your tip and repositioning it to fit your profile and facial features.  The next step is to select a facial plastic surgeon and discuss in detail the surgical plan and your specific goals.  Best wishes as you pursue your treatment.

Behrad Elmiyeh, MBBS, MRCS, FRCS (ORL HNS) · Answer

Thank you for your questions and for sharing your photographs.
Rhinoplasty can deal with all your legitimate concerns and improve your nasal appearance.External (open) Rhinoplasty will provide a greater exposure and hence allow more accurate surgery to take place. Therefore the benefit can be significantly more than having a small scar over the columella skin.
I would suggest that you consult with an expert rhinoplasty surgeon and discuss what you do and do not like about your nose.
You should expect a full detailed examination of your nose is required to assess your nasal skin, cartilage, bony structures, and your nasal airway/ breathing. This will allow the surgeon to evaluate your nasal appearance and its relation to your facial features.
The use of manipulated (morphed) digital clinical photography provides a platform for discussion as to your desires and expectations. Such images are not a guarantee of exact results, but a great tool to ensure that you and your surgeon are on the same wavelength.
It is paramount that you have a realistic expectation before proceeding with this surgery.
Best wishes,

Rhinoplasty for bulbous, upturned nose

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