My nose goes down when I smile and has a slight bump. What do you recommend? Am I a candidate for Rhinoplasty? (Photos)

Question

I've always hated my nose since I was in my teens . . I am 27 and I'm really looking into getting a rhinoplasty . . My nose goes down when I smile and it has a small curve . . I want my tip lifted and thinner front part of my nose . My biggest issue is how it goes down especially when I smile and the slight hump , I feel like it makes my face unbalanced . What do you recommend ? Am I a good candidate ?

Douglas L. Vander Woude, MD · Answer

Thank you for your question and photos.  From what I can see in the photos, I think you could get a nice improvement with a rhinoplasty.  A little thinner through the lower half of the nose and tip.  You might benefit from a cartilage graft for tip support.  Make sure you talk with a couple of Board Certified Plastic Surgeons with experience in rhinoplasty specifically.

Pejman Aflaki, MD · Answer

Hello and thank you for the question and sharing your photos. I believe you are a good candidate for rhinoplasty. You have a bulbous and drooping nasal tip, which gets worse when you smile. You will benefit from a rhinoplasty procedure focusing on nasal tip refinement (both conservative narrowing and cephalic rotation). There are a variety of techniques that can be utilized, including trimming the nasal tip cartilage, suturing techniques, cartilage grafting or combination of those. My best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon with extensive experience in performing rhinoplasty. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. In particular, pay attention to your surgeon's experience with rhinoplasty. Best,
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Tanveer Janjua, MD · Answer

A rhinoplasty will certainly help reduce the droopy appearance by lifting the tip, reducing the hump on the nose. One point of caution is that you have thick skin and getting good tip definition can be hard. RegardsDr. J

Zoran Potparic, MD · Answer

You seem to be a good rhinoplasty candidate; small refinements would improve your overall balance. Some patients (over 60%) have one or two small muscles between upper lip and nose which contract when patient smiles and pull the nose tip down. Muscle(s) are removed in the course of procedure, if needed. In person consultation with a board certified plastic or ENT surgeon with expertise in nose surgery is recommended. Good luck.

Ronald J. Edelson, MD · Answer

Your nose is not bad at all but it could be reduced a little, the bump removed and the tip refined. Go on a few consults with experienced surgeons. Don’t be surprised if the recommendations vary. There are many ways to perform a rhinoplasty in your case.

Jeffrey Joseph, MD, FACS · Answer

Thanks for the question and photos.   In your case, rotating your tip while narrowing it slightly would be nice. I’d also lower your dorsum to improve your profile, as well.

Daniel Barrett, MD · Answer

Dear AnnaXooXo,
it is hard to tell for sure without an examination. Based on your photos, it looks like rhinoplasty could provide you with desired results. 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

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty, a cephalic rotation of your tip to turn up your tip slightly, and a dorsal hump reduction. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon. If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon.Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Victor Manuel Agudelo, MD · Answer

Hello, You are a very good candidate for a a rhinoplasty. Your nose tip can be narrowed and lifted, adding support and weakening the tip depressor muscles so it will no longer go down while you smile. Your bridge can be evened and narrowed too,

Seckin Ulusoy, MD · Answer

Greetings;First of all, thanks for the nice question.As far as I can see in your photos, 
1. You have a light hump on the ridge of the nose (and you want a feminine curve). 
2. In addition, the nose, which starts at the level of your lashes aestetically, we call this "Nasofrontal angle"and angle normally it is 125 degrees. Your nose starts a little lower (Low Nasofrontal angle).
 3. In the meantime, your nose is little wider (Bulbosity)  in your tip. 
4. Also, the muscle that pulls down below, which we call the depressor septum nasi, works a bit strong and your nose moves down while laughing.My advice;  Your nose looks very suitable for closed preservation nose aesthetics. In my own practice, I apply this technique ( Closed let-down rhinoplasty) to my patients like you. With this method, we protect our own natural nasal ridge, removing bone and cartilage structures in the deeper part and finally curving your nose ridge as I want. It is also possible to do all nose tip maneuvers with the same method too.In general, you are a very suitable candidate for rhinoplasty surgery. I think your problems can be solved quite easily and with successful surgery you can get results that will make you much happier. My advice to you for all these procedures is to contact two or three nose surgeons ( ENT or Plastic Surgery)  first, and whichever lies more in your heart, it will be to continue with him or her.Good luck

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