Rhinoplasty with nostril tuck - Will this help me achieve my goal of a smaller, narrower nose with nostril symmetry? (photos)

Thank you for your question. You are an excellent candidate for rhinoplasty. I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Please refer to my previous answer regarding nose narrowing and tip deprojection -- the tip deprojection will improve the nostril appearance as the skin re-drapes around the modified cartilage framework of the tip as it is deprojected. Essentially, the skin envelope contracts around the deprojected tip cartilage, in essence making the nostrils smaller and optimizing symmetry.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

You have very strong tip cartilages. It is those cartilages that make the tip look wide, and make the tip sit low, especially on the 3/4 views, like the second photo you submitted of the 5. Work on those tip cartilages could narrow and elevate the tip. Almost everyone sees *some* sort of asymmetry after surgery, but when that asymmetry appears on a smaller nose, they look smaller, too.
How *much* to elevate the tip, or narrow the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)
Finally, 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 in particular needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, 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.