Am I a candidate for rhinoplasty & lip lift? (never had surgery before) (Photos)

Question

I had a consult with a plastic surgeon but he said my nose was perfect and not to get work done because it could make it worse. He said not to smile and it won't looked crooked. He agreed I have a bulbous tip that plunges on smiling but said surgery couldn't fix that. One side of my tip curves down, the bones on the side are wide, columella sticks out, low radix and there's a slight curve. My upper lip also sicks out horizontally and wanted to get a lift to make it more vertical up and down.

Alan Gonzalez, MD, FACS · Answer

Dear @A2DD thank you for your question and showing your pictures. It is possible to improve your nose, but it is determined by the surgical possibilities of each doctor. You can improve the relationship between the dorsum and the tip and also generate the support that prevents it from lowering through a cartilage graft in the tip. Similarly with non-surgical treatments such as botox and acid can also improve the proportion of the upper lip. Best wishes! Alan Gonzalez MD, FACS.

Yannis Alexandrides, MD, FACS · Answer

In regards to the Rhinoplasty procedure, I believe an open tip Rhinoplasty will help you to achieve the goal of a more defined tip without the tipping on smiling. That can also be combined with an Alar Base Reduction to lessen the width in that area.

I am unable to give you guidance on the Lip Lift surgery, as the pictures that you have sent do not represent the lip in a reposed position.

I am unable to give you guidance on the Lip Lift surgery, as the pictures that you have sent do not represent the lip in a reposed position.

Marc Polacco, MD · Answer

Thank you for your question. I would disagree with your consultation. I'd say that your rhinoplasty concerns are reasonable and addressable. Regarding your lip, there I would be a bit more careful. Typically a surgeon will take meticulous measurements and help decide how much shorter the lip can be made.

Zoran Potparic, MD · Answer

Although you do not look like one of rhinoplasty candidates that you can spot from another corner of the room, based on these photos, you are a candidate for rhinoplasty. Subtle changes in the tip, sides, width would definitely bring improvement. However, you have to have an experienced rhinoplasty surgeon to do it. I am not sure that you need anything done with your upper lip? Good luck.

Tanveer Janjua, MD · Answer

I think you can make subtle changes that will make the nose more to your liking. A conservative closed approach tip plasty and alarplasty will give you refinement without making it look obvious.
You can have the lower half of the nose (tip and nostrils) addressed without breaking the nasal bones. Tip-plasty can address the bulbous tip either through closed or open approach to make it narrow and refined.
Alarplasty is a very fine and quick procedure that can narrow the nostrils and reduce the flare to soften the appearance. It has other names as well like ‘Weir Excisions’ or ‘Nostril Reduction’. However, it is important to note that asymmetry of nostrils is common and cannot be corrected with alarplasty.
 Both of these can be done under local anethesia.
Watch the video link below.
Regards
Dr. J

Ronald J. Edelson, MD · Answer

Your nose isn’t bad but a few refinements could improve its overall look. I would make it slimmer and possibly reduced the nostrils. Lip lift s I don’t care for. I know they are all the rage right now but I am not impressed by the results

Sam Naficy, MD, FACS · Answer

Rhinoplasty can definitely improve reduced tip support (a tip that droops more with smiling).  It's true that in some cases, asymmetry may be related to facial asymmetry and not correctable with rhinoplasty

Daniel Barrett, MD · Answer

Dear A2DD,
it is hard to tell for sure without an examination. Based on your photos, you would benefit from rhinoplasty. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Barry M. Weintraub, MD, FACS · Answer

I think it would be a reasonable idea in your case to seek a second opinion.  I disagree with what your surgeon said about the rhinoplasty -- and just based on the photos, it looks like there is room for improvement with a subtle, conservative rhinoplasty surgery. I disagree even more that you should not smile! Smiling is very healthy for the mind, body and soul. In my practice, I routinely correct plunging tips and bulbous tips, and I decrease nasal width and hanging columellas. In an experienced surgeon’s hands, all should be doable. Regarding the lip lift, I would agree that you do not need a lift lip at this time. A lift lip is used to help shorten the distance between the bottom of the nose and the upper lip. In your case, this distance appears not too long, so you would not be a good candidate. Instead, you might consider lip fillers to help improve the height of the lips.

Itziar Amaia Cinta Egana, MD · Answer

Yes I think your nose can be improve, refined and straight also the lip lift. Its better to have a consultation and a CT scan to have a surgery plan that its adequate for you