Rhinoplasty. What would you do? (photo)

I want a nose job, & I'm curious to see what you would do to my nose. My primary concern is the tip of my nose. It's too fat & droopy. When I smile, my nose gets wider (front view) & droopier (side view). I have a very slight bump on my nose (it's obvious when I touch my nose, but can't really be seen in photos). I'm also not happy with the size of my nose. I have small features on my face (which I don't want surgery on) & my nose is overpowering.

Doctor Answers 10


Dear Nosejobgirly874, As far as the width and bulbousness of the nose, that can clearly be reduced with rhinoplasty. Regarding the nose getting wider on the front view when you smile, this is unique to each person but really is not affected by rhinoplasty. The muscles that cause the smiling are on your cheek bones and attached to the corners of the mouth. Everyone’s smile anatomy and physiology is unique, and yours just happens to pull the nostrils into a flared position. Regarding the droopiness on the side view with smiling, this is related to a muscle that attaches to the base of the nose (columella) and the front of the maxilla bone just under the nose being overactive and can be weakened at the time of surgery. I hope this has been helpful to you. Robert D. Wilcox, M.D.

Dallas Plastic Surgeon
4.1 out of 5 stars 22 reviews

Your Rhinoplasty Should Be Very Limited And Accepting Of Factors That Cannot Be Overcome.

Dear Nosejobgirly874:

You are an attractive lady; you articulated and demonstrated perfectly what you are unhappy with.Yes, your nose is a bit wide in the lower half or tip area, and that can certainly be improved.The droopiness can also be improved.

What is happening is that you have an overactive depressor septi muscle, which is an extension of the upper lip muscle that tends to draw the nose down with smile.However, another portion of the facial muscles cannot be altered, and that is the muscles in the cheek that tend to widen your nose when you smile.Even with the tip narrower, you will still have that phenomenon.

Regarding the small bump on your nose: I could not open the photos to see more details, but, of course, in consultation, any surgeon will be happy to explain the pros and cons of dealing with that.It appears that your nose is not grossly oversize, in terms of its height nor at the bridge.

My best recommendation is to have several consultations with surgeons who are considered "Master" nasal surgeons.These would be surgeons in which rhinoplasty is the most important procedure in their practice.

I am a big fan of computer imaging, whereby you will be able to see the particular results of the surgery.A computer imaging session is very important because it allows you to input to your surgeon what you wish to have, and then he can demonstrate on the computer screen what he believes is feasible and achievable.If you have a meeting of the minds, then it is quite likely that you will be satisfied.

Do your homework, visit websites, see a lot of before and after photos, read books, and get up to speed on the anatomy of the nose.

Typically, the greatest process for success is directly related on how much research you devote to the procedure before it starts.

Best wishes,

Robert Kotler, MD, FACS



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

What would I do .

Hi nosejobgirly, I have looked at your pictures and agree with your assessment. Your tip is somewhat large and drooping. There is a small dorsal hump and the bony width is too wide. I would perform and open rhinoplasty which would allow me to nerrow your tip by removal of some cartilage and suture reshaping the remaining cartilage The dorsal hump can be removed and osteotomies can be performed to narrow the nasal bones. I would also shorten or lift the tip to improve the drooping. I would need to see you or better photos to determine if the nostrils need to be narrowed. I would also have to examine the inside to see if the septum needs to be addressed.

William H. Sabbagh, MD
Detroit Plastic Surgeon
4.7 out of 5 stars 37 reviews

Rhinoplasty for drooping, bulbous and wide tip

Reducing the bulbous tip is best addressed with tip suturing techniques of the lower lateral cartilages. This will narrow And refine the tip cartilages as well as give slight rotation. Releasing of the depressor septi ligament will prevent the tip from drooping upon smiling. Virtual rhinoplasty software is available on our website along with an extensive rhinoplasty photo gallery located on the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Rhinoplasty for the wide nose with bulbous tip etc.

lRhinoplasty for the wide nose with bulbous tip etc. involves conservative refining the tip, slight hump reduction , narrowing the nostrils to create a natural , non operated look.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Rhinoplasty. What would you do?

You can achieve a natural result with a refined, lifted tip and a smoother bridge with closed rhinoplasty. The tip can also be deprojected if you would like.

Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews


Hi there. Rhinoplasty (nose reshaping surgery) to address a bulbous nasal tip is a feasible maneuver. Most likely, an “open rhinoplasty” (where the soft tissues are gently elevated to allow direct access to the tip cartilages) will be required. These tip cartilages are then sculpted and sutured to refine the nasal tip.

Hope this is helpful. Best wishes.

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

What Would You Do To Improve My Nose?

First I would sit down with you to clarify what you want to achieve, discussing the concerns you describe. I agree with your critique but you should understand any subtleties before making a final decision.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Rhinoplasty. What would you do?

I would ONLY recommend IN PERSON evaluations vs over the internet in any rhinoplasty. Take the time to see at least 3 boarded surgeon in your city..//

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Nose changes

It sounds like you know the changes you would like to see in your nose. After a consultation and examination including making morphed images of your nose, my job would be to create the image you have chosen and informing you of any risks associated with the procedure.

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 62 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.