Do I Need a Rhinoplasty with a Chin Implant, Nostril Reduction and Nasal Spine Removal? (photo)

I have had various opinions and can't figure out what to do. Based on my profile, which of the following might I need? * Chin implant * Nasal spine (bone) removed (mine is large) * Nostril reduction The reason I say nostril reduction is since my nose will get pushed back, I don't want the nostrils to flare and get wide. One doctor said removing the spine would cause problems. One said remove it. One didn't know you could. Please help! I don't know what to do. Thanks!

Doctor Answers 17

Do I Need a Rhinoplasty with a Chin Implant, Nostril Reduction and Nasal Spine Removal?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

  IMHO, from the photos provided, your nasal tip is over-projected with columellar show, wide nasal tip and a slight dorsal hump of both cartilage and bone.  The chin is a bit weak as seen on the profile view.  Rhinoplasty and a chin implant would be able to address all of these issue, however...IMO, it's very important that the angle of tip rotation not be increased in your particular case.  Be sure that your Rhinoplasty Suirgeon understands and follows the proper aesthettics of facial (and nassl ) beauty for the creation of a naturally, more attractive nose and face.  

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Rhinoplasty, chin implant, nostril reduction and nasal spine removal

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Removing a portion of the nasal spine can be performed quite easily through a closed rhinoplasty.  Trimming the caudal septum will also reduce the columellar show.  Nostril reduction is only done at the very end of the operation and it really depends upon how flared the nostrils are after the procedure is completed.  Look for a very experienced rhinoplasty surgeon to get the results that you are looking for.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Do I Need a Rhinoplasty with a Chin Implant, Nostril Reduction and Nasal Spine Removal? (

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your nose is considered a ' tension nose'  which is due to over growth of the septum. Yes, you do need to have the nasal spine removed, lower the dorsum and possibly use spreader grafts as well as alar reduction which can be determined intraoperatively after above procedures. 

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

You nose is long and this is tenting the tip

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It appears that your nose is long. This is because the septum (cartilage between the two sides of the nose) is long and possibly the cartilage that forms the tip of your nose may be long also. By shaving back the end of the septum and removing some of the overlying nasal tip cartilage, your nose will shorten. It will also raise the tip ,which looks slightly droopy. As far as the nostrils are concerned, they probably won't change shape significantly with nasal shortening. I usually make the decision to trim the alar skin, which forms the nostril during the procedure.

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 27 reviews

Nasal spine removal and chin implant during rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From the limited photos submitted deprojecting your tip would help bring your nose in better balance with the rest of your face. You have an elongated septum that has created a short, tethered upper lip and excess columellar show.

These issues can all be addressed by an experienced rhinoplasty surgeon. If your septum is straight one can perform a tongue in groove setback of your nasal tip cartilages to help stabilize your tip while at the same time addressing your concerns.

Whether you would need a chin implant depends on your aesthetic. In-office digital morphing can help with this decision. Without seeing your base view it's hard to say whether nostril reduction would be needed to prevent nostril flare.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Nasal Reduction with Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The most important thing you should do is consult with surgeons who specialize in rhinoplasty surgery. On the basis of the pictures I suggest you decrease your tip projection and reduce the nasal spine. Without seeing the base of your nose I cannot tell if the nostrils should be reduced, but this will probably be necessary and is something that you and your surgeon will consider before surgery. I do not recommend a chin implant.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Do I need a chin implant?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You need a consult with computer imaging. You have a very overprotected nose which may have an enlarged nasal spine. It gives you the illusion of a weak chin and shallow radix. Seeing different versions with computer morphing will help you understand the interrelationships and effects of various changes such as chin implant, radix augmentation, nasal spine reduction. Your nostrils will flare and likely need to be reduced.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Nasal surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Rhinoplasty can achieve different results for different people. The photos are helpful to get a general idea about what to offer, but an in person exam is essential to really evlauate you properly. Unless you want a very strong chin, I think you chin is ok.  There are seveal different manuevers that can help the tip, nostril, alar base relationship but again I would suggest seeing a doctor to review them in person.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Rhinoplasty with chin implant

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In order to help you with your decision I think it would be beneficial for you to visit with a physician or 2 who can perform video imagining.  This will give you and your physician an idea of what you are looking for and help guide the physician to make the appropriate changes.  It is the most accurate way to see what all those changes would look like and give the physician a goal to obtain.  All of the procedures you ask about seem appropriate from the profile picture, but you'll never know what a chin implant might look like on you until you do some video imaging.

Robert M. Jensen, MD
Medford Plastic Surgeon
4.8 out of 5 stars 46 reviews

Rhinoplasty struts and grafts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your photos show a prominent columella with a tethered upper lip and long front to back nasal tip to cheek distance. It is hard to know what would be best without a face to face examination but reduction of the forward tip projection, removal of the anterior nasal spine, reduction of the lower end of the septal cartilage and dividing the upper lip to nose muscle may suffice.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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.