Could I get surgery to fix my swooped nose tip? (Photos)

Question

I think my nose suits my face ok, but there are some things that bug me everyday, such as the small bump on my bridge but especially how the tip of my nose swoops to the left, and makes my right nostril look significantly more apparent than the left and lower. Can this be fixed for a more symmetrical and neat appearance?

Selcuk Inanli, MD · Answer

Hello! Thank you for your question!As far as I can see from your photo Your wishes can be fixed with a single operation.For get rid of this image I recommend you Rhinoplasty.It would be better face to face consultation.Best regards!

Steven M. Denenberg, MD · Answer

I see the bump, of course. But I don't think the nostril asymmetry is due to the small asymmetry of the lower part of the bridge, where it moves to the left. I think the nostril asymmetry is due to the tip cartilages--there are two cartilages that form your tip, give it its width, and they hold the tip out away from the face and also hold the tip down. They line the rim of the cartilages, and asymmetries of the tip cartilages are much more likely to be the culprit, except in the case of someone whose bridge asymmetry is *much* more severe than yours.There are a couple caveats about operating on your nose, too. When a bump is taken off the bridge, it tens to make the nose *look* longer, as if the tip had dropped. Your nose would look much too long if the bump were removed and the tip were not elevated a touch. I'll bet that morphs would prove that.Then, you didn't post a true profile, but I can't tell whether your nose is strong in its forward projection away from your face. If it is, the tip could be brought back, and maybe narrowed a touch, at the same time.There's an advantage to addressing all these areas. It helps keep the nose looking natural when some changes are made, and also with the asymmetry: asymmetries are impossible to correct 100%, but when the nose is overall smaller like that, any remaining asymmetries or things that bug you after surgery would reside on a smaller, less prominent nose, and thus would probably bug you less.
How *much* to lower the bump, or elevate the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should always be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and only the surgeon has that information and judgment. Another aside: I also recommend that you not show morphs made by one surgeon to a different surgeon. If a surgeon makes his *own* morphs, you get to see whether he understands the important issues of your nose, and how your nose should be changed. But if you show the surgeon someone else's morphs, and he says "Of course I can make your nose look like that," then you don't really know if he fully understands, or even recognizes, the important changes shown in those morphs. And you don't know if he can make those changes during surgery.)
Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.
Your nose is also a perfect example of why computer imaging by the operating surgeon is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?

Suleyman Tas, MD, FEBOPRAS · Answer

Hello,Thank you for your question. Based on your pictures you seem to be a good candidate for rhinoplasty preferably with the Closed Atraumatic Technique which will protect the anatomy of the nose, strenghten the weak parts and avoid tissue damage inside the nose. You could benefit from the shortening of the nose, dorsal hump removal and refinement of the tip. Possible breathing issues can be addressed at the same time. Meet at least top 3 doctors to find out the best options in your case. More before and after pictures in the attached link. Best Regards

Zoran Potparic, MD · Answer

Based on these photos you are excellent candidate for rhinoplasty; shortening of nose, removal of small hump and refinement of the tip should address your major concerns. In person consultation with a board certified plastic or ENT surgeon with good reputation in nose surgery should be your next step. Good luck.

Nirmal Nathan, MD · Answer

Dear starg1rl123,There are may options, both surgical and non-surgical that can address your dorsal hump and asymmetry. I do agree that with a rhinoplasty cartilage grafting will likely be necessary to achieve your goals and re-balance your nose. Consult with a board certified plastic surgeon to learn more.Good luck,Nirmal R. Nathan, M.D.
  
Certified, American Board of Plastic Surgery
  Member, American Society of Plastic Surgeons
  Fellowship-trained Craniofacial Surgeon
  RealSelf Top Doctor

Pejman Aflaki, MD · Answer

Hello and thank you for the question and sharing your photos. I believe you are a good candidate for rhinoplasty. You have a dorsal hump and a wide nasal tip and alar flaring. You will benefit from reduction of your dorsal hump, nasal tip refinement and likely alar base reduction. My best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon with extensive experience in performing rhinoplasty. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. In particular, pay attention to your surgeon's experience with rhinoplasty. Best,
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Ronald J. Edelson, MD · Answer

There are several things I would change about your nose. There is a small bump in the bridge and your nose is too long. There are many ways to approach a nose like yours , so it’s worth going on more than one consult.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty, a cephalic rotation of your tip to turn up your tip slightly, and a dorsal hump reduction. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon. If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon.Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Seckin Ulusoy, MD · Answer

Greetings;First of all, thanks for the nice question and photos. As you can see from your photos, you have a very light hump on your nose ridge. There is also weakness in your wings cartilage( Alar cartilage) at the bottom of the nose and the distance between your face and the nose, which we call this projection, is also more length. There is also some width in your nose tip area (Bulbosity). It also looks like thin skin.Under these circumstances, my first suggestion to you would be to have a full nose aesthetic surgery instead of only tip plasty. In my own practice, I apply preservation closed nose aesthetics to patients similar to you. With this method, it is possible to support weakness in your nose wings and shorten your nose tip facial distance (Deprojection surgery) with nose tip aesthetics.Under these circumstances, my advice to you will be to contact two or three board certified nose surgeons and follow closely, and to have surgery, whichever feels more suitable for your heart.Good luck to you

Kris M. Reddy, MD, FACS · Answer

Based on the photos, you appear to be a good candidate for a primary rhinoplasty. Consult in person with an experienced and expert board certified plastic surgeon to understand your options.

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