How can I correct my long nose with overhanging tip, slight bump and deviated septum? (Photo)

Question

I have a fairly prominent, long nose with a slight bump, large nostrils, deviated septum and large nose tip, that overhangs my top lip when I smile (which is my major concern) - what can be done to improve the appearance of my nose and smile?

Raymond Goh, MBBS (Hons), FRACS (Plast) · Answer

Hi there.
From the photos provided, you are on par with your list of undesired features. The one feature I wish to point out is the plunging tip upon smiling. To correct this, one needs to support the nose, in a very rigid way, so as to counteract the pull of the muscle that lies between your nose and upper lip area. This will generally require a cartilage graft to support the tip.
Have a chat to a surgeon who has extensive experience with rhinoplasty to see what your best treatment option is. 
All the very best.
Dr Ray Goh
Valley Plastic Surgery

Jeremy Hunt, MBBS, FRACS · Answer

Hi,The issue with the tip is one of lack of support and this is compounded by the fact that yuor nose is long, and hangs over the end of the septum. When you smile the smile muscles pull on the base of the nose and this pulls the tip down off the end of the setptmthe answer will be a rhinoplasty to rebalence the size of your nose and add support to the tip. this can come in different fashions and will need to be designed to balence the other proportions of your face. The key will be a full examination and surgical plan from there, but a " plunging tip deformity" is not an uncommon issue and one that can be corrected predictably.I hope that is of some helpJeremy Hunt

Elliot M. Heller, MD · Answer

What you want done is completely up to you.Rhinoplasty which typically starts at $5,500 depending on the area you live. To make sure you get the best possible result, the surgeon should perform a detailed exam of the nose and provide a realistic goal that you and your surgeon agree upon. Rhinoplasty are permanent, but with age facial features do change. Find a surgeon and go for a consult. Maybe try and see if the Dr can do photo imaging to show you what he or she can achieve.

William H. Sabbagh, MD · Answer

Hi Walkerwalk, based on your pictures it appears that you are a good candidate for a rhinoplasty and septoplasty.  Because of the slight asymmetry in your tip I would use an open approach to fully visualize the tip cartilages.  Sometimes there is much more irregularity than shows on external appearance.  I would remove the small bump on the bridge and maybe narrow the nasal bones.  The tip would be elevated, shortening the nose and correcting the droop when you smile.  Occasionally the muscle that pull the tip down may need to be cut.  The tip will also be made smaller and the asymmetry corrected.  The septum will also be straightened.  The exact details should be discussed in as much detail as you want during your consultation.

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