I want to fix my wide fat ugly nose. I want to slim down the tip and bring down the nostrils. Recommendations? (photos)

Hi @feme88. Thank you for sharing your photos. You are an excellent candidate for a rhinoplasty. I recommend seeing an expert rhinoplasty specialist for an in person examination. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures.

Best of Luck,

Dr. Nima

Thank you for your photos and Question.
The operation will be done by using the latest Ultrasonic Rhinoplasty device Piezo®:

In traditional Rhinoplasty, surgical instruments known as rasps and osteotomies (hammer and chisel) are used to reshape the nasal bones by removing the hump and/or narrowing the nasal bone width. These tools are relatively imprecise and their use can lead to contour irregularities, etc. if not used in the proper manner. Recently, a technology that uses sound waves has been developed to contour nasal bones in a precise and far less traumatic way when compared to traditional techniques. Ultrasonic, or Piezo, Rhinoplasty is now the most advanced technology available for minimally traumatic nasal bone reshaping and hump removal during Rhinoplasty. There will be hardly any bruising and swelling which will make the recovery period a lot easier for the patient.

Here is what you need.Tip-plasty and Alarplasty

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

Your nose can certainly be narrowed using standard rhinoplasty techniques. You should also consider alar wedge resections to reduce the flare of the nostrils. That will give a nice narrowing effect.

Dear feme88,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from a rhinoplasty. If you are considering a surgery, I would suggest you to 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

Dr. Chao hereThank you for your question.Yes we can refine the your nose with open rhinoplasty to become slim and straight. You would be a good candidate.James J. Chao, MD, FACS

Thank you for your question. Obtaining a “slimmer” nose could be achieved with a standard rhinoplasty. In my hands, this would be done with an open approach. Breaking the bones in the upper vault would also be necessary to slim the nose in your situation. A separate alar rim procedure could also narrow the alar bases. 

A rhinoplasty can help add more definition and refinement to the nose. If the skin is thick it may limit how 'slim' it gets but there is definitely some room for improvement.

Your desired improvement is realistic.Every nose is different and unique to that individual. If the appearance of your nose concerns you enough to do something about it, it can be improved with a natural artistically performed rhinoplasty. What would be the best option and exact procedure would depend on an in person examination (not just an online consultation) and discussion about desired outcome. Excellent results can be achieved with either a closed or open technique.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you exactly what to do and how technically to do it based on limited photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon with extensive rhinoplasty experience certified by the American Board of Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. 

Robert Singer, M.D., FACS 

La Jolla, California

A closed rhinoplasty approach can accomplish narrowing the bridge line and narrowing the nasal tip cartilages. To narrow the bridge line requires osteotomies placed in the nasal bones to narrow the upper two thirds of the nose. To narrow the tip requires removal of excess wide cartilages in the nasal to area. Thick skin in the tip of the nose prevents refinement in that area, so it's important to have realistic expectations. It's impossible to bring the nostrils down, however they can be narrowed with an alar-plasty.