What else Can I Do to Achieve the Perfect Nose for my Shape in Addition to Rhinoplasty and Septoplasty? (photo)

So I've met with the surgeon and have decided to get Rhinoplasty along with my Septoplasty. In your opinion (medical terminology) what changes should I bring up to my surgeon that will help with achieving a perfect nose for my face? (Assuming we haven't discussed already) I do not like my side profile, the width and how it droops when i smile. By lifting the tip make the width more narrow? Thank you for your time and feedback.

Doctor Answers 8


Nobody can guarantee you the perfect nose, but the best rhinoplasty results start with finding the right surgeon. In your case I would refine the tip and shorten it, remove the hump, and fracture the bones to narrow it. I think you are also a good candidate to reduce the size of your nostrils by what is known as an alar wedge resection. You can expect a nice result, but again choose your surgeon carefully based on their experience and the results of previous work that you have seen.

San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Best Advice When Consulting with Rhinoplasty Surgeon

Hi Ms. Lopez,   It sounds like you know what you want to achieve with your rhinoplasty.  The most important aspect to discuss with your rhinoplasty surgeon is to be assured that your rhinoplasty surgeon understands your goals, what bothers you, what you will be happy with, and that your surgeon is confident that those goals can be achieved.  Good luck and be well.   Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Specific Techniques for Your Rhinoplasty

Thank you for the question and the great pics! First, I want to say that you are starting from a good place -- your nose may not be exactly what you like now, but it is symmetric and well proportioned to your other facial features. Second, addressing your specific concerns would include reduction in the osseocartilaginous hump (the bump on the bridge), refinement of the bulbous nasal tip (generally with cartilage shaving and sutures), and possibly a slight upward rotation of the tip (which can be performed in a variety of different ways. Preoperative imaging can be a great way to figure out exactly what you want -- and what is possible.  Best of luck moving forward!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 110 reviews

Natural-looking Rhinoplasty for a nose that maximizes your overall look

Thanks for your question and photos. Based on your photos, the main things I would suggest considering:

1. On side view, your nasal dorsum, you can view this as either a small doral hump (which can be reduced), or a radix deficiency, which can be augmented with a radix graft). This is a matter of aesthetic preference, and I would suggest looking at pre-operative imaging of both to see which "new you" you prefer. 

2.  Cephalic trim, domal suture techniques to refine your nasal tip (depending on your skin thickness and strength of your cartilage, you may also require tip grafting to give you additional shape and refinement.

3. Cut depressor nasi septi muscle (this is the muscle that makes your nose pull down when you smile)

In-person examination is an important part of a thorough evaluation, and pre-operative photos and image-morphing can help make sure you and your surgeon are on the same page when it comes to surgical goals.  Pre-operative imaging is also a great way to explore different possibilities that you may not have thought of such as a radix graft. 

Dara Liotta, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

What else Can I Do to Achieve the Perfect Nose for my Shape in Addition to Rhinoplasty and Septoplasty?


Thank you for your question and pictures. Though it is very helpful to see your photos, they do not provide the same information gained during an  exam in person. It appears that you may lack support in the nasal tip, which can cause the tip to droop, especially when smiling. I do think there is a small dorsal hump, that could be removed to improve the profile and possible narrow the bridge of your nose. Also some refinement of the nasal tip and a cartilage graft to support the tip may be possible. Usually by raising the tip with added cartilage support will help make the tip and nostrils appear narrower. Depending on how thick your nasal skin is, there may be some limitation to how much this can be changed. You should discuss exactly what your concerns are with your surgeon, so that he/she can advise you if your goals are realistic. Good luck.

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
4.9 out of 5 stars 69 reviews

What else Can I Do to Achieve the Perfect Nose for my Shape in Addition to Rhinoplasty and Septoplasty?

Dear v.lo

Thank you for your question.  Dorsal hump removal, narrowing of the nasal sidewalls, refining the nasal tip, and I think you have the type of face that would look good with a slight supra-tip break.  Also, would consider bringing the collumela down slightly for a little more collumela show.  Finally would consider a small chin implant for overall balance of your profile.

Best wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

What else Can I Do to Achieve the Perfect Nose for my Shape in Addition to Rhinoplasty and Septoplasty?

         Your tip can be lifted and refined.  The hump can be reduced, and the bridge, narrowed.  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 492 reviews

Specific changes for your rhinoplasty

 The specific changes to consider would be a hump removal which involves shaving down both bone and cartilage along the dorsum. Tip refinement would involve a combination of cartilage removal and tip suturing techniques to narrow and refine the bulbous tip. To shorten the nose and raise the tip up a little bit this is accomplished with by trimming the membranous and cartilaginous caudal septum. Also important to make sure  to release the depressor septi ligament( if it is present), so your nose  does not droop  and lengthen upon  smiling.  For examples of rhinoplasty patients similar to your own, please see our photo  Gallery Link  below.

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.