Rhinoplasty for multiple isssues
What you have presented is a classic situation for rhinoplasty. A personal evaluation with a doctor is required to answer you fully. However, the issues you describe usually can be addressed with a septoplasty and rhinoplasty. The specifics of shape changes, etc that you desire should be evaluated carefully with your surgeon. You may find that computer imaging is helpful.
Good luck to you.
Rhinoplasty can help several areas
Rhinoplasty is an elegant procedure with the capability to address a lot of issues. To achieve the best result possible the surgeon must look at how altering one area affects other areas of the nose. I would suggest that you visit a couple of board certified plastic surgeons to get there recommendations.
Rhinoplasty to change a wide tip and add definition
To give an official opinion I would at least need to see a profile picture. It appears that your concern which we call 'boxy tip' is caused by a vertically wide lower lateral cartilage ( the lower cartilage responsible for nasal form) that is also splayed apart centrally. Usually to refine the tip in a nose like yours, the top of this cartilage is trimmed, any fatty or fibrous tissue between the two paired cartilages is removed and a suture technique is used to bring them closer centrally. The result is a thinner, more defined, and elevated tip. I hope this helps!
All the best,
Rian A. Maercks M.D.
Filing Down the Dorsal Hump Without Osteotomy?
From the picture and your concerns, I would recommend septorhinoplasty with the following goals:
1. Shortening the nose a bit
2. Narrowing the nasal tip
3. Straightening the septum
4. Placing septal cartilage batten grafts in the mid third of your nose (narrow now) to make it more triangular and prevent collapse in the years to come
These should give your nose a more feminine look
Multiple issues can be addressed during rhinoplasty
Rhinoplasty can certainly address asymmetries of the nose. Osteotomies would be performed to straighten and narrow the pyramid. A spreader graft would need to be placed on the right side where the upper lateral cartilage has been pushed inward, downward, and probably compounding the airways issues. A deviated septum is fixed through an operation called a septoplasty, which is usually billed to the patient’s medical insurance out of medical necessity. Feminization and refinement of the tip can be performed through small cartilage removal from the tip. A bump can be shaved off the bridge, which is usually composed of bone and cartilage.
A rhinoplasty (nose surgery) should make your nose fit your face better so they see your entire face and do not focus on your nose. I encourage you to watch my video to see what can be accomplished. If there is breathing problems, these can be addressed at the same time but even if the deviation is helped(ie you can breathe better) that may not help with straightening your nose as you see it on the outside.
Various things can be done including grafts to help that but you should realize that there is a good chance that it will still be or may become crooked again at some point after your surgery. Unfortunately, the cartilage has been one way for a long time and it may spring back to that way. In either case, you are a good candidate, and I wish you luck!
It is imperative to see other views of your nose, especially the profile. Nevertheless, most noses such as yours can be refined to improve the contour by an experienced nasal surgeon, to improve the contour.
Your requests for rhinoplasty sound reasonable. It is hard to suggest too many things without seeing your other photographic views and performing an in-person exam. Certainly deviation can be corrected and the tip refined some.
A rhinoplasty corrects multiple unattractive features in one operation.
All of the items you mentioned can be corrected at one time. The hard part is finding an experienced rhinoplasty surgeon who does natural noses. See several surgeons and their live patients to get the kind of nose you want.
You can have an improvement with a septorhinoplasty. This will help straighten your nose as well as remove the dorsal hump and elevate the tip of your nose.
Make sure you see a board certified plastic surgeon and go over what bothers you about your nose. Be specific about what you want.