Rhinoplasty of my very special nose (photo)
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Doctor Answers 8
Not An Easy Case, But Rhinoplasty Will Improve Your Appearance
Your concerns regarding the suitability for rhinoplasty are correct.Yes, the nose is big, although it is wider more than tall, and that is important.Yes, you have a bulbous tip and, frankly, the floor of the nostrils, or sill, is very wide.However, most noses can be improved.Yes, your skin is thick and oily, but there are other patients with thick and oily skin who have had improvement, so that does not rule it out.The photos you submitted are very helpful.
Here are what I consider the important points to be considered:First, the tip is significantly wider than the bridge, according to the photos.That means the tip has to be sculptured.Tip sculpture is a little more challenging when the cartilage is covered with thick, oily skin, but nonetheless, it is possible to narrow that tip.
Also, after surgery, depending on the result and perhaps the need to further thin the tip, this can often be done with the help of cortisone injections.That does not take place until several months after surgery, but it is very helpful in people with thick skin.The other important thing is that the floor of your nostrils are very wide and, frankly, if the outer walls of the nostrils are brought in (the wings), that would go a long way to narrow your nose because, frankly, the bottom of your nose, as it attaches to the upper lip, is what is causing the nose to look particularly wide.The proportion and width of your nose to the width of your face at that level is not acceptable.
Now, narrowing of the nostrils, the so-called Weir procedure, does require an external incision that runs along the floor of the nostril and then outside into the natural groove between the attachment of the nostril to the lip and cheek, but this is an accepted procedure and works very nicely.
I think you should do some good investigations.You need to have consultations, but before you go for consultations, study up.You need to do a lot of homework.I have examples on my website of similar situations.I have examples in my books, and certainly, other practices have similar examples.
Frankly, you are best served if you will see surgeons whose practice is slanted towards nose work.It is very important to see someone who has a long track of experience doing difficult cases as yours, but I would not despair.You just need to have as much education as possible and spend time with surgeons whose level of experience and talent match the task at hand.
I hope this is helpful to you.
Robert Kotler, MD, FACS
Over 4,500 nasal procedures performed
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Author, THE ESSENTIAL COSMETIC SURGERY COMPANION
Rhinoplasty with thick skin
Your nose is typically ethnic with thick and oily skin. You should seek surgeons that have a lot of experience with this type of surgery. Below is a link to videos that describe treatment of ethnic noses and bulbous tips.
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Potential thick skin rhinoplasty results
I agree with my colleagues that your nose can be refined. However, thick skin will lead to results that might be less than what you are hoping for. It is very important to have realistic expectations prior to rhinoplasty. It is truly your chosen surgeon's responsibility to give you a realistic description of what you can expect from surgery.
Rhinoplasty of a bulbous tip?
Your nose can be cosmetically improved with a rhinoplasty, but you must be realistic about the potential outcome with the thickness of your nasal skin and underlying nasal anatomy.
Keep in mind that following the exact advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
Your nose can be refined to create a more pleasant appearance. Find a surgeon who can digitally alter your image to show you what might be accomplished
Rhinoplasty of my very special nose
While you do have have very thick skin, the tip, alar base, and the nose as a whole can be refined.
Find a board certified plastic surgeon 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
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.