I have a very bulbous tip and want to know if my desired outcome from Rhinoplasty is unrealistic. I honestly don't know the exact part of my nose that I feel need to be changed; however, I do have ideas of what I would like the outcome to be. Can plastic surgeons pretty much create whatever shape they desire?
Is It Possible to Re-sculpt Nose to Any Shape?
Doctor Answers 9
Computer Imaging Can Help Clarify Your Goals and Set Your Expectations
It is possible for correction of a bulbous tip to appear natural as long as the nose is proportional and in balance with the other facial features. Your prospective rhinoplasty surgeon should be able to show you before and after computer simulations. Many rhinoplasty surgeons use computer imaging, and recently 3D rhinoplasty imaging has become available.
The goals for rhinoplasty should be agreed upon by both the surgeon and the patient. Every rhinoplasty patient is unique and so should their rhinoplasty -- i.e, there is no "one nose fits all". For the nose to look natural, it must be in balance and harmony with the other facial features.
One way to gain a better understanding of how rhinoplasty would change your appearance is to visit with a rhinoplasty specialist who show you what your potential rhinoplasty resuls would look like. There are several methods that rhinoplasty surgeons use in their practices to help patients understand what their surgical result may look like. Some surgeons prefer to use tracing paper overlying the patient's photographs. This can give patients a rough idea of what to expect from surgery. Computer imaging, frequently called computer morphing, is a very effective way of communicating the intended surgical results and to set goals for surgery.
Most recently, 3D computer imaging and analysis has become available. This new technology allow the surgeon and the patient to view a preoperative image in 3 dimensions. The image can be rotated and viewed from any angle. Morphing tools allow the result to be simulated in 3D and viewed from any angle (http://cbs11tv.com/health/Rhinoplasty.plastic.surgery.2.1077611.html).
It is very important to realize that all imaging and drawings are used to set goals for surgery. There will always be some subtle variations from the simulations. However, the real value in this preoperative tool is that it can increase the surgeon's understanding of the patient's goals and desires.
Each nose has it own unique limitations.
The bulbous tip can be refined through our tip rhinoplasty technique but there are some limitations to the shape that can be achieved through surgery. Computer imaging would help in this area for communication purposes prior to undergoing a rhinoplasty surgery.
Not everything is possible
There are definitely many changes that can be made to your nose. However, not everything is possible. You are limited by your anatomy. Also, we have to balance function and aesthetics. We could create you a very cute small nose, but then you would not be able to breathe. All of these factors go into consideration when planning rhinoplasty.
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Several factors can affect perfect Rhinoplasty results
As a plastic surgeon who performs many secondary and revision rhinoplasties, I am often humbled by the difficulty in creating the perfect nose. Often, I feel as if the world is against me. Why? Because a small change in shape in the nose is quite obvious and disconcerting.
Although, I may leave the OR with a perfect result in hand, scarring, minimal amounts of bleeding and post-operative sabotage (patients wake up with their nose smashed against their love ones arm, aggressive kissing at parties, trying to kiss your dog a week after surgery) can all work against a perfect result. It is said that 15% of all nosejobs require some type of revision. A good plastic surgeon will possess many tools or techniques that can shape, primp and cajole a nose into a beautiful state.
Your case is quite common. You need narrowing of the nose from top to bottom and base, you need a narrowing of the tip, I assume you need to have a little extra projection of the tip (although I cannot make that ssessment from this angle), you need thinning of the skin to make the inner changes more visible externally, and all this has to be done without changing your ethnicity. It sounds like a lot but is quite common.
My advice to you is to shoot for the stars and expect the moon and you will end up happy!
A nose is not made of clay
I use to have a professor that would tell me, "If patients were made of clay, I could guarantee them a perfect result!". Unfortunately, noses are not made of clay.
What makes it worse, is that even if you sculpt it perfectly at the end of the operation, noses "settle" and heal. This is unpredictable unless you build the nose out of extremely strong cartilage such as rib cartilage. However, although this can be carved into a straight shape, it can warp unpredicatably after several months. This has made some surgeons utilize a metal rod down the cartilage graft but as you can see, this can get quite extreme.
So, the brief answer is sadly, no.
No, you cannot make any nose shape
I tell my patients who have an"ethnic nose" that we want to refine the nose - not make it into a caucasian nose. This usually means narrowing the base of the nostrils, narrowing the tip and the nasal bones. It may required the tip to be set forward. But the result no one wants is that "done" appearing nose. I have done famous actresses who still look black and have a more refined, undetectable nasal surgery result. Make sure you go to a rhinoplastic surgeon who has a great deal of experience doing "ethnic" noses.
No, plastic surgeons cannot sculpt a nose to any shape that is desired. Ethnic noses such as yours are most difficult to reshape, although there are techniques that allow the experienced ethnic rhinoplastic surgeon to make the nose appear smaller, less bulbous in the tip with more definition of the tip, and less wide both at the nostrils and at the bridge.
Rhinoplastic surgeons must work with the precious material (the human nose) and are limited in the degree of change by the anatomy. When too much is attempted it can turn into the nightmare that is Michael Jackson's nose.
Good luck and be well.
You can have a more refined tip.
Hi! We certainly cannot create any shape we want, but we have gotten quite good at sculpturing the tip with internal stitches and grafts.
You do want a final nose that looks natural and that looks like it belongs to your face.
We wish we could but often cannot
Each patient is like a unique canvas and each patient can only have certain degrees of change achieved. In other words, there is no way to be able to give a patient any result they want. The same is true in hairdressing and any other personal appearance enhancement.
You have a difficult starting point given your ethnicity, broad nasal tip and thick nasal tip skin. All of these limit how much change you can achieve in a rhinoplasty. What you need to do is go to an expert in what is called "ethnic rhinoplasty" and see what changes they think they can give you and then see if these are changes you would like.
Dr. Rollin Daniel in So Cal is considered an expert in this. I am sure there is someone in SF but I don't happen to know them.
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.