Can This Rhinoplasty Result Be Achieved? What Do You Recommend? (photo)

I've asked this question before but the doctors told me to have a more realistic approach.Now I'm having a rhinoplasty this june...Can I achieve the result in the pictures added? I did a lot of research over these eight months and according to me I need an alarplasty,a nasal bone osteotomy and a tip lift.Tell me if I need any other procedure or exactly what I should get done to achieve the result?

Doctor Answers 6

Your goals now appear more realistic. Yet, computer simulation is just that--simulation!

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Your main change in goal photographs (from previous question to present one) shows the base nasal width more realistically proportioned. In order for ANY nasal base width narrowing, Weir excisions must be performed in addition to any of the other nasal changes carried out during rhinoplasty.

Your upper third of the nose can be narrowed, any hump removed, and the tip cartilages refined, retruded and elevated appropriately (slightly), but the nasal base width is NOT affected by any of these surgical manipulations. The Weir excisions (alarplasty) are necessary in order to achieve the desired degree of nasal base narrowing. Sometimes this can be hard to judge accurately until the results of the rest of the nasal changes have been achieved. Thus, it may be appropriate to consider requesting that your surgeon defer the Weir incisions (alarplasty) until the rest of your nasal changes have healed completely, adding this later (can be done under local anesthesia). Of course, alarplasty can always be part of your planned rhinoplasty surgery, but once performed, it cannot be "taken back." You can always request more (up to a point, or nostril size is decreased too much), but you can't go back!

What you really need is to find a rhinoplasty surgeon who you can trust to make the assessments and judgements that you are attempting to make yourself. It is certainly OK to be clear about goals, participate actively in discussion, and be proactive in asking questions, but at some point you have to relax and leave the driving to us (like the old Greyhound bus commercials). Micromanaging your own surgery is neither wise nor helpful (nor possible once you're asleep)! Think about plastic surgeons who undergo plastic surgery themselves!

Best wishes!

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews


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It is difficult to answer your question without seeing profile pictures – with your thick skin you may not be able to get the narrowing you desire if you profile is also being reduced

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Questions and tips before rhinoplasty consultation and surgery

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Photographs are an ideal addition to the rhinoplasty consultation in my Los Angeles office.  I would begin by taking lateral, oblique, and anterior images and see what proportions can be improved.  Narrowing of your nasal bridge, as seen in the photos, will not add aesthetic proportion if performed alone.  Your projection and lateral profile are important in your assessment of your rhinoplasty. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews


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Thanks for the photos, but remember what can be achieved with computer simulation may not be achieved with surgery.  Thick tissues do not refine as easily as thinner tissues.  

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Rhinoplasty and expectations

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By looking at your photograph it appears that your expectations for the tip and middle area "osteotomy" region should be achievable and would appear to be a natural and aesthetically pleasing result. However your after photograph shows the base of the nose, between the eyes to a little bit to thin, which offsets the proportions of the nose then making the tip appear large. See a good experienced surgeon and if they have a digital imaging computer which I use in the consultation process they can show you their proposed surgical result. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Realistic Expectations with Rhinoplasty

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My response is based on 1 picture without the opportunity to examine you and see your entire nose. I feel that bony portion of your nose is too narrow. It is difficult to determine if your nasal base is also too narrow. Listen to the recommendations of an experienced rhinoplasty surgeon; it sounds like you are getting honest advice from the surgeons you have seen.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 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.