What procedures could produce this rhinoplasty result? (Photos)

Question

I am interested in knowing what specific rhinoplasty techniques can produce this result (right image) and if this is even a realistic goal.

Andrew Miller, MD · Answer

From the photo, it looks like you are a great candidate for rhinoplasty. It looks like you primarily narrowed the tip which can be done with some standard techniques for a great result that looks natural. Be sure to see rhinoplasty expert for consultation.

Semih Yildiz, MD, FEBOPRAS · Answer

Compared with the original image on the left, the right-side edit mainly narrows and straightens the bony and middle bridge, creates cleaner dorsal lines, and gives the tip slightly more definition. The nostril base appears largely unchanged. That is a reasonable direction to discuss, but a single frontal edit does not show the profile, basal view, breathing anatomy, or how much of the apparent change comes from image warping.

A surgical plan might use controlled medial and lateral osteotomies to narrow or straighten the nasal bones, followed by careful middle-vault reconstruction so the bridge remains smooth and the internal valves stay open. Tip refinement could involve conservative cartilage reshaping and sutures, with support from a columellar strut or septal extension graft if needed. Alar-base excision does not appear necessary from this comparison unless standardized basal and smiling views show true excessive width.

The exact maneuvers depend on bone width, septal alignment, lower-lateral cartilage shape, skin thickness, and airway function. Over-narrowing can create pinched dorsal lines, asymmetry, visible irregularities, or breathing problems. Bring the edit to a rhinoplasty consultation and request standardized frontal, profile, oblique, and basal simulations. The image is useful for communicating a subtle goal, but it cannot predict an exact result or substitute for examination.

Mune Gowda, MD · Answer

Based on the pictures, it seems a minimum change in the nose except the tip. The patient seems to have mainly had a tip rhinoplasty, with perhaps some smoothing of the bridge (as it was narrow to start with).

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. A surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

M. Zakir Sabry, MD · Answer

Hi There. Yes, this is a reasonable goal to pursue. A combination of tip refinement, cartilage shaving (cephalic trim), alar base resection, and narrowing of the nasal vault (osteotomy) should help achieve a good outcome.

Eric M. Joseph, MD · Answer

There is no particular technique for artfully narrowing somebody's nasal tip appearance, especially when they have thin nasal skin, like you appear to have. We all have our own recipes for dealing with these issues, and at least partially, they has to do with removing some of the excessive tip cartilage that is causing your tip to appear wide. If you have severe dissatisfaction with the appearance of your nose, please consider meeting with several reputable rhinoplasty specialists who offer computer Imaging so you can see what to expect. I hope this helps! Sincerely, Dr Joseph

Gary M. Horndeski, MD · Answer

The base of your nose is wide so you will need alar narrowing. This is done by cutting a wedge out inside the nostril. The tip needs to be refined and this is done by using the sutures to pull the cartilage together at the junction of the medial crura. This surgery takes less than 2 hours to perform under general anesthesia and costs $8,000.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Steven M. Denenberg, MD · Answer

It looks as though the two cartilages that form the tip of your nose are strong, and they make the tip look wide. Narrowing those cartilages can be accomplished in a rhinoplasty, with some reasonable predictability, in expert hands. The woman whose photos I posted with this response had strong cartilages that were narrowed in her operation.
It also looks as though you narrowed the distance, measured horizontally, between the edges of your nostril skin from the front view. *Some* of that can usually be accomplished, though maybe not quite as much as you drew.

Kyle Kimura, MD · Answer

Great question! 
There are multiple different techniques that can be performed during a rhinoplasty to achieve the result that you are aiming for. For example, cephalic trim with lateral crural steal or lateral crural repositioning are some common techniques that are used for tip refinement (or narrowing). However, there are a number of other factors that will determine whether that goal is realistic or not. Particularly, evaluating the thickness of the skin/soft tissue at the tip is very important in deciding how refined of a result you may be able to achive. 
I think your best option is to schedule a consultation with a plastic surgeon that specializes in rhinoplasty to perform a thorough evaluation and discuss your surgical candidacy.
Hope this helps and best of luck!Kyle Kimura, MD

Zoran Potparic, MD · Answer

It is very likely that in the hands of an experienced board certified plastic surgeon, expert in rhinoplasty, you may achieve similar result. In person consultation is recommended.

What procedures could produce this rhinoplasty result? (Photos)

Answers (14)

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