Refine nasal tip, fix breathing, mini osteotomy. Will these changes look drastic? (photo)

Question

Good morning everyone! I’m soon having a rhinoplasty to correct my breathing issues, focusing on my septum, alar cartilages (as they affect breathing), and inferior concha. At the same time, I’d like to refine my nasal tip, as I find it asymmetrical and quite bulbous. I’ve consulted a well-known surgeon in my area, and we created some morphs, which I’ll be adding. However, I’d love to hear other perspectives! I don’t want drastic changes—I like my nose’s character and feel it suits my face. My biggest fear is ending up with an overly “done” look (like a Barbie nose). I don’t want a pointy or overly small nose, just subtle refinements that keep my features balanced. My surgeon agrees that my tip asymmetry should be corrected and suggests slight refinement, as he feels it draws too much attention. He also mentioned that when correcting the functional aspects, the tip will need to be moved slightly upwards (minimally) for better tension. Additionally, he recommends a mini osteotomy to prevent the nose from looking too prominent and to improve harmony. Lastly, he plans small incisions to lower my nostrils slightly, making them less visible from the front and side. Do you think these changes will look drastic or would you agree? How can I ensure the result stays natural? Is this the right approach? Should I go for the mini osteotomy and nostril adjustment? I’ve attached pictures and morphs and would love to hear your thoughts and opinions!

Zoran Potparic, MD · Answer

You seem to have well developed plan; discussion with your surgeon should cover all concerns. Chin augmentation should be considered as an option. Good luck.

Lucian Ion, FRCS · Answer

Thank you for your question and for sharing your photographs.

The treatment plan proposed by your surgeon appears very sensible. If the procedure focuses on conservative refinements, it is unlikely that you would perceive the outcome as over-corrected. The computer simulations also support this approach, indicating a natural and balanced result.

With subtle changes of this nature, most people find that their peers and colleagues do not notice a significant difference, even when comparing before-and-after photographs.

Ronald J. Edelson, MD · Answer

I agree that you are a good candidate for some minor changes in your nose. The same as you describe. Selection of the right surgeon is always the most important factor in achieving the result you want. It appears you are comfortable with your choice. Best wishes!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. With good surgical technique, you could have an outstanding result.

I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up.  Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag.  If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, that can also be a red flag.   Long-term results are much more meaningful than on table results or 1 week post-op results.   Selfie’s can also be fun to look at, but these can often have a filter and do not represent true longterm results because of this and are not as valuable as real longterm in-office before and after photographs on your surgeon’s website.

I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Eric M. Joseph, MD · Answer

It is very important that you and your surgeon are on the same page, before having surgery. Based on the single frontal photo that you posted, you appear to have a relatively pleasing nasal appearance, therefore, it is difficult to advise what might look good. Please consider re-asking your question with multiple photos, and with the morphed images that you spoke about in your narrative. Thanks a lot. Sincerely, Dr Joseph

Refine nasal tip, fix breathing, mini osteotomy. Will these changes look drastic? (photo)

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Refine nasal tip, fix breathing, mini osteotomy. Will these changes look drastic? (photo)

Answers (7)

Answer: Rhinoplasty and chin augmentation

Answer: Rhinoplasty and chin augmentation

Answer: Reduction septo-rhinoplasty

Answer: Reduction septo-rhinoplasty

Answer: Rhinoplasty

Answer: Rhinoplasty

Recommended reading

Everything you need to know about Rhinoplasty

Answer: Rhinoplasty

Answer: Rhinoplasty

Answer: Computer Imaging may be helpful for establishing rhinoplasty goals.

Answer: Computer Imaging may be helpful for establishing rhinoplasty goals.

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Our mission is to create a world where every investment in modern beauty is Worth It.