I have multiple issues with my nose, what is a reasonable result I can expect? (photos)

1: Nose is asymmetrical / crooked. -I want my nose straightened, both the bridge, lateral side walls and tip. 2: Bulbous drooping tip and drooping columella. -I want the tip refined and lifted. The columella removed. And also achieve a shorter appearance to my nose. 3: Widening of the lateral side walls, nostrils and top. -I would like to get my nose narrowed and even. 4: Small dorsal bump. -I want this removed. 5: Large drooping nostrils. -Made smaller and aesthetically pleasing.

Doctor Answers 8

Reasonable expectation from Rhinoplasty....

Rhinoplasty can nicely improve quite a few of the concerns you have about your nose.  There are many techniques in Rhinoplasty to make a nose straighter and I'm sure you could benefit from these efforts.  Indeed the tip of your nose is bulbous and that could be nicely improved.  Your nostril asymmetry is probably due to a septum deviation which is also likely much of the cause for the crookedness.  Again, this could be improved with Rhinoplasty.  The dorsal hump can be taken down, although the radix looks low.   Building up the radix a small amount might be a nice option to make your nose appear smaller.  As to the drooping of your nose, I can't comment without seeing your forehead and chin in the side view.  Likely though, the tip could come up some and the columella can be raised decreasing nostril show from the side.  A special graft called an alar contour graft can help the retracted edge of your nostril that also plays a role in showing too much inside your nose.  I hope you find these comments helpful.  

Virginia Beach Plastic Surgeon
4.8 out of 5 stars 37 reviews

Rhinoplasty Candidate

Dear Princesssally, You have done a good job describing the concerns you have with your nose and most of the areas that need addressing. You would be an excellent candidate for rhinoplasty to help balance your profile and overall facial aesthetics. During consultation imaging can be performed to show you the proposed changes to your nose taking into consideration your desires as well as your nasal anatomy and skin thickness. Once the desired nose is agreed upon the techniques that will be used to attain the desired result will be discussed. You will also have the opportunity to review before and after photographs to ensure the surgeon performs natural looking rhinoplasty procedures. Once these steps have been finsihed you can make an informed decision regarding rhinoplasty surgery. Personally, I believe you should have an outstanding result in the hands of an expert surgeon that will be very rewarding for you. See examples in the link below and video above. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Reasonable Expectations for Revision Rhinoplasty

I agree with your evaluation of you nose plus a slightly over projected tip. Your nasal appearance can be significantly improved if you have surgery with a surgeon who specializes in rhinoplasty surgery and devotes most of their practice to this work.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Nose multiple concerns - rhinoplasty needed

You have done an excellent job of presenting your concerns and wishes. All of your concerns can be addressed. I would suggest that you bring in pictures of noses you like and do not like at the time of your consultation. This will help with communication and your vision of what you mean by some of the terms you used. I also like using computer imaging to help with conceptualization of post operative possibilities.  The picture I have attached had some of the same requests as you. 

Michael Kulick, MD, DDS
San Francisco Plastic Surgeon
4.2 out of 5 stars 11 reviews

Rhinoplasty for the asymmetric nose with bulbous tip etc.

Rhinoplasty for the asymmetric nose with bulbous tip etc. can do all you listed but not with perfect results. Your tip is overprotected and your septum is off and the tip is very asymmetric. Your nose in my opinion based on more than 35 years of rhinoplasty is that it should be done using the open technique. See a very experienced rhinoplasty surgeon who does natural noses and look at revisions since you will need alar batten grafts etc. like a revision nose.

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


Complicated set of issues and will require a careful evaluation.  You do not state whether you have had previous surgery or if this is developmental but we see these types of deformities after poorly controlled rhinoplasty. certainly an open approach is required to balance the bridge, straighten the septum, rebuild or reinforce the tip and allow the skin to redrape over the new framework. Get more than one opinion.

R. Laurence Berkowitz, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 13 reviews

Complex rhinoplasty considerations #plasticsurgery

I agree - based on your photos, you have a number of aesthetic and probably functional issues with your nose. Open rhinoplasty with refinement of the nasal dorsum, tip and nostril shape and support will make some improvements.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

I have multiple issues with my nose, what is a reasonable result I can expect?

From the limited photographs, it appears that there is very thick sebaceous skin In the tip of the nose which will blunt most of the changes with the rhinoplasty procedure. There are some issues it can be addressed such as straightening the nose and making it look more symmetrical and shaving down the dorsal hump. The  bridge line can also be narrowed with osteotomies which will also help straighten the nose.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 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.