Can Rhinoplasty Make my Nose (Nasal Tip, Alars, Everything) Significantly Smaller? (Transgender Patient) (photo)

I am a male-to-female transsexual in the early thirties and I'm seeking for facial feminization surgery including feminizing rhinoplasty. Concerning my nose, I have a bulbous nasal tip. Is it possible through methods like "defatting", "cartilage grafts" etc. to make my nose significantly smaller? I would like to have a small, pointy nose which is slightly upturned, something like the typical Caucasian nose and which would give me an unmistakenly more feminine look. Thank you in advance.

Doctor Answers 6

Can Rhinoplasty Make my Nose (Nasal Tip, Alars, Everything) Significantly Smaller? (Transgender Patient)

Thank you for your question. There are procedures that can be done to refine your tip and make it look more feminine. You say that you want to make it “significantly smaller”. I would caution you about this since you may end up not liking the result. From an esthetic analysis point of view (keeping in mind feminine proportions), your nose does not need much reduction. It would however benefit from some reduction in key areas. I agree that making the tip smaller would definitely help feminize it. However, making the whole nose smaller may simply make your nose not fit with the rest of your face. Also, I would caution you about upturning your nose further. It also seems to fall within the esthetic proportions of a feminine nose and upturning it further would be unnatural looking. This is especially true if you are a taller individual. Have you considered a chin implant? Your chin is a little more set back and augmenting it slightly will help make your nose look smaller as well. There are many excellent Facial Plastic Surgeons who have a niche in transgender surgery. One that comes to mind is Dr. Spiegel in Boston. He has taken care of transgender patients from around the world and if I am not mistaken does consultations over the Internet. He may be a great resource for you. He does the full gamut of facial feminization. I wish you good luck with your transformation!

Columbus Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Can Rhinoplasty Make my Nose (Nasal Tip, Alars, Everything) Significantly Smaller?

 Rhinoplasty can make the nose significantly smaller however, from the photos included, the external thick portion of the ala would remain the same.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Rhinoplasty for bulbous tip reduction and feminization

 Reducing the bulbous tip is best addressed with a combination of cartilage removal and tip suturing techniques. The cartilaginous dorsum is also reduced to give more of a inward slope, and to  decrease the overall projection. For examples of what a rhinoplasty can accomplish, please see our  rhinoplasty photo gallery below for noses similar to your own

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews


Yes, your nose can be made smaller.  Redefining your tip and narrowing the alar base will give a nice result.  Make sure you go to a board-certified Facial Plastic Surgeon.  They can also help with voice (pitch) altering surgery and reducing the Adam's apple, if needed.  Take care

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

Keep your expectations reasonable

Rhinoplasty can definitely produce a more feminine nose. One of the biggest limitations  is the thickness of your skin. Looking at your pictures, a petite well defined tip may not be realistic for you. If you decide have surgery with realistic expectations you will likely be very satisfied. 

Joshua Rosenberg, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Can Rhinoplasty Make my Nose (Nasal Tip, Alars, Everything) Significantly Smaller? (Transgender Patient)

            Your tip can be made smaller with a closed rhinoplasty approach, and alar base reduction can be performed at the same time to help create a more feminine nose.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

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.