Dear mimispears in San Diego:
Your nose is a bit flat and bulbous and wide. The nose is not overly large for your face because you have a fairly tall face with a high forehead. Just doing the nostrils is not valuable in my opinion. What you need is to have the tip refined by the standard techniques. Because these photos do not show your profile, I cannot make any comment about that. I would look through various options.
You want to do your homework before consultation. Prepare well for your consultation. When you search, look for rhinoplasty super-specialists. These are surgeons whose practice is the majority or entirely devoted to rhinoplasty, septoplasty, and related procedures. This would include both primary and revision rhinoplasty surgery. Why not have the most specialized talent in your service? Consider how much experience the surgeon has doing the procedure you are considering. We all get better at what we do with time and so those surgeons who have a long run of experience are the ones who have learned the most from experience. Residency and fellowship are where the learning begins, but for all of us, time and experience is where the education continues.
Part of your preparation for consultation should be preparing a list of questions beforehand. Bring a notepad or ipad or laptop with you and take notes as the surgeon answers the question you are asking. You should spend more time with the surgeon than with the office administrative staff, because you need to get a sense of whether you are comfortable with the doctor. You should not feel rushed that you are on a consultation conveyer belt. If the presentation by the office staff seems a bit to “salesie” that is a bit of a yellow or red light. Take a friend or relative along since two heads are better than one in gaining information and understanding. In the end, the purpose of the consultation is for you to be educated and be comfortable, not to be “ sold”. Ask yourself two key questions: “Is this surgeon teaching me or selling?” And secondly, “Can I put my life and my face into this particular surgeon’s hands? Can I trust him/her?”
There are excellent books out there that you can read and use to study up. It is worth the homework time you put in up front so that you make the right decision with respect to choosing a surgeon who has the talent, experience, and degree of super-specialization that you certainly want to have.
When you visit doctor’s websites, the most important feature on the site is the before and after gallery. If there are just a few examples of rhinoplasty or revision rhinoplasty, you wonder how much experience the surgeon has performing such surgeries. There need to be dozens and dozens of examples. The more examples there are, the more likely you will see one or more that demonstrate situations similar to yours. Look closely at the photos for natural results. That is what you want. Nobody wants to carry a sign saying “I have had a rhinoplasty.”
Reviews on review sites, particularly RealSelf are very important and should be carefully digested. The larger the number of reviews the most accurate the picture of the practice and particularly the doctor. A consensus is generally correct.
A consultation without computer imaging is, in my opinion, of much less value. Why shouldn’t you see the predicted result of the procedure the doctor is proposing? At consultation, photos are taken of you and loaded into a computer system that morphs your present appearance into the anticipated “after” based on the nasal surgeons input. Imaging is an incomparable learning tool because it provides a forum for doctor and patient agreement on what would satisfy the patient and what is, in the doctor’s opinion, achievable. After all, cosmetic surgery is 100% visual. It is about appearance, so without a visual evidence of what is planned, how can you make a decision as to whether or not you might be satisfied. Talking about it is worthless. To anticipate a successful outcome, there must be a meeting of the minds between surgeon and patient.
Robert Kotler, MD, FACS
Over 4,500 nasal procedures performed
Dear mimispears, The choice of having a rhinoplasty should come after a fully informed consultation aided with digital imaging to show you the proposed surgical results. Thus taking into consideration your nasal anatomy and taking into consideration if the projected final results would be your desired result. I would not consider doing just your nostrils as this will give you an unnatural looking result. It is best that the surgery is designed around the fact that the nose is a three dimensional structure and altering one portion of the nose will result in other portions being off set. It is important to have a very natural looking rhinoplasty result which could be achieved by addressing the entire nose. Refining the nasal tip with suturing techniques, performing osteotomies to narrow the bridge, and then determining what other refinements need to be performed to allow you a nose that looks like you were born with it. A smaller more refined version of your nose without it looking like a rhinoplasty. Seek consultations with some experts in the field, look at the before and after photographs to ensure natural looking rhinoplasty results and then make a very informed decision if rhinoplasty surgery is for you. See some examples in the link below and video above. Best regards, Michael V. Elam, M.D.
Rhinoplasty to adjust the tip
- It might be beneficial for you to go see a rhinoplasty specialist who can examine you and give you some information
- Ultimately, the decision will be up to you and what you want
- I have found that patient who do not know what they want will ultimately be unhappy, even with very nice looking results so we do not operate on them
- In my opinion, it would be nice if the tip was a little more refined and narrowed, the nostrils may not need to be adjusted
Rhinoplasty candidate for bulbous tip reduction
A full set of facial photographs are required for making a determination of what can and cannot be accomplished with your nose. The bulbous tip is reduced with suture techniques and a conservative cartilage removal applied to the lower lateral cartilages of the nasal tip area. Rhinoplasty does not include a complete tip readjustment, just refine what you already have. Thick skin in the tip of the nose can be a significant impediment to seeing refinement in that area. Digital computer imaging will be helpful to understand what can be accomplished with your nose. For more information and many before and after results of bulbous tip reduction, please see the link and the video below
Rhinoplasty for Tip Refinement
Some day you'll be happy that you have a "baby face". Your tip can be narrowed and refined so it is more proportional to the rest of your nose. I need to see pictures of your nose as described on my website to make more specific suggestions.
Tip rhinoplasty at age 20?
Thank you for your photos. You do appear to be a good candidate for reduction of your bulbous tip and possible narrowing of your nostrils. Meet with a board-certified plastic surgeon or facial plastic surgeon to discuss options and review photographs of other patients as well as imaged photographs of yourself.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California
Rhinoplasty will certainly be able to reshape and create the balance. If you want the best idea of what is possible for your nose, do your due diligence, find an experienced surgeon, and have him/her evaluate you in person and discuss your options. Looking at computer-morphed images with your surgeon during consultation will give you a good idea of what is possible, and also give you a great chance to convey to your surgeon what you envision.