Who Decides Nose Shape for Rhinoplasty?

I want to know, could I get any shape for nose or the one the doctor selects for Rhinoplasty?

Doctor Answers 21

Who Decides Nasal Contour?

The answer to your question is your surgeon, you, and your genes. There are physical limitations. Regardless of the skill of my surgeon. he/she could not sculpt Paris Hilton's nose on my face ( see my photo on Real Self ). All kidding aside, you do ask a very good question. During consultation, patient and physician should thoroughly discuss what will be done, how it will be done, and establish reasonable goals.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Shape of nose for rhinoplasty depends on many factors.

The shape of the nose for a rhinoplasty depends on many factors. It is important to discuss with your surgeons your concerns and general ideas that you would like to see for your new nose. It is important that the physician can deliver rhinoplasty results that the patient desires. It is also important that the nose looks natural and balanced with the face and does not appear to be operated upon. Computer imaging is also important in the discussion process to get a clear understanding of exactly what the patient’s needs, wants, and desires are regarding their rhinoplasty.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

You should come up with a nose shape together

You should look at rhinoplasty as creating a significant improvement over the nose you currently have. It is not possible to create any nose during a rhinoplasty surgery, but you should go into a consultation with an idea of what kind of nose you would like. After the surgeon examines you, he or she will determine if that goal is possible.

Every patient should be treated like an individual and if you are looking at pictures in a surgeon's office where every nose is done the same, then something is wrong. Some patients want the bridge with more of a slope while others want it straight. Some people want the tip raised more while others want it raised less. It is the surgeon's job to take into consideration what you desire and combine that with what is possible, and to provide a natural outcome.

Good luck.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 206 reviews

Consider having computer imaging.

I find computer imaging to be a wonderful tool. It will give you a preview of the possible changes in the shape of your nose. With this technique you will have a better understanding of what is possible and what the finished product will look like. If your Rhinoplasty surgeon does not offer this service, I would get a second opinion with a surgeon that can perform computer imaging of your nose. Then you will see if your expectations can be met.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.6 out of 5 stars 36 reviews

Nasal shape - desired vs. possible

Dear Pravin,

It is good to know what kind of result you are interested in attaining, but with some patients, it is not possible to achieve a particular end result. A simple example is a patient with a very large nose with thick skin - it is not possible to achieve a very petite, refined nose. Surgeons cannot significantly alter the skin, and we have to account for how the skin will react to surgery. If you are unhappy with what you are hearing from one physician, visit with several rhinoplasty surgeons. Tell them your desires, and they will tell you what they think is possible to achieve within the confines of your anatomy. Hopefully the result that will make you happy is possible, but if not, maybe you should reconsider having cosmetic surgery.

Best regards,

Dr. B

Michael A. Bogdan, MD, FACS
Dallas Plastic Surgeon
4.9 out of 5 stars 67 reviews

Nose shapes

It's not clear why you and your plastic surgeon aren't agreeing to the ideal nasal shape for your face. Your plastic surgeon is likely looking out for your best interest and if you can't reach an agreement together then consider it a blessing and move on to a second opinion.

If it is your first nasal surgery, then your goals should be identified and the technique is up to your ABPS Board Certified Plastic Surgeon of preference. However if you have had more than one nasal operation it's possible that he just can't confidently do what you want due to your tissue limitations. Remember that sometimes images can be made with software to better communicate ideals, but these are no guarantee to what the result will look like- so you may base decisions on a picture that you may never look like.

That being said, sometimes we just can't get what we want. If you have a request that is not normal to your ABPS Board Certified Plastic Surgeon or that he simply is not comfortable with -- you need to move on. You could be requesting something that he may not feel comfortable commiting to, this is not uncommon. The last thing you want is someone overpromising results in this operation.

I suggest you obtain a second opinion of another ABPS board certified plastic surgeon and if you get the same answer, you should rethink your request.

Ricardo A. Meade, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 121 reviews

The shape of your nose after surgery...

The shape of your nose after rhinoplasty depends on its structural starting point, the thickness of the skin over it and the talent and experience of your surgeon.  You should discuss what you want very specifically and ask your doctor if your expectations are realistic.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Only for Pinocchio


You, the patient can choose the shape of your nose within the limits of your basic nasal structure.  This can be discussed with your board certified plastic surgeon.  Good luck!

Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 48 reviews


The original shape of your nose is genetically determined.  With this in mind, a rhinoplasty surgeon has to work with the tissue that he is given.   From this, the nose can be contoured to improve the shape while maintaining function.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Every nose imposes limits on how much it can be changed

Bone structure, cartilage thickness and flexibility, skin oiliness or dryness and depth all impose limits on how much any surgeon can change the nose.

There are other issues that must be considered. Size and shape of head, distance between eyes, dimensions of the lip, structure of the upper jaw bone all influence the surgeons opportunities or lack of them to make a change that is satisfactory to the patient.

All the above explains the need for a thorough and thoughtful consultion. Computer imaging can be very helpful since it allows the prospective patient to visualize the surgeons conception of what is achieavable.

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 87 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.