Very thin skin, septum deviated, pointed tip and one side looks different from the other side. What do you recommend? (photos)

Question

What would you recommend so that my nose is less pointed and long? I have very thin skin on my nose and septum is deviated which is more noticeable in photos than in person. I want a small gradual projection with nose tip reduction but I've been told that it's going to be a difficult surgery because of my nose tip and also the results may be variable due to my thin skin. I'm so torn as to whether I should risk it or not.

Steven M. Denenberg, MD · Answer

You didn't really post a true profile view, which would be important for making a good pre-op morph to establish a goal for the operation, but your first photo does show a strongly-projecting nose. "Projecting" means that it comes out far away from your face. 
The woman in the short video that I posted with this answer had the tip of her nose de-projected a significant amount."Long" actually means something different. It means that the nose is long from top to bottom, a drooping-tip nose. You have more a "projecting" nose.As in the video, it is definitely possible to significantly bring the tip back closer to your face and make it less prominent. However, 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, requiring 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. 
Your nose is also a perfect example of why computer imaging 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?

Lucian Ion, FRCS · Answer

Thank you for your question and submitting your photographs.
The characteristics of your nasal shape and skin offer both difficulties and opportunities. 
As you have rightly mentioned, the deviation of the septum drives several elements of asymmetry:
- the contour from the front
- the difference in the semi-profiles or oblique views
- the difference in position of the nasal tip domes with the left side being lower than the right
The left nasal tip cartilage appears to be more "crumpled" under the dome and would require straightening.
The advantage that you have is that the shape of the nasal tip domes may only need changing on the left side and the right side can be used as reference.
The septal deviation would also need to be corrected.
One of the characteristics of thin nasal skin is that during surgery it behaves like thicker skin which can be deceptive. As a result, the contour of the structure under thin skin needs to be smoother than under thicker skin. 
In the beginning, after your surgery, it may look more rounded for a while and you may find this off-putting, but thin nasal skin has a tendency to settle quicker. Some patients have little swelling from the beginning making their recovery easier.

Donald B. Yoo, MD, FACS · Answer

The best way to determine what specific changes will look good on your face, and what changes are surgically possible, is to do your research to find the top rhinoplasty specialists and consult with several of them in person. Good luck

Kenneth Hughes, MD · Answer

Hello. Great question. Thank you for your pictures. However, a personal examination is needed to properly evaluate your mose. Please schedule a consultation with a board certified plastic surgeon for a detailed surgical plan to achieve your desired results.

Regan Thomas, MD · Answer

As most surgeons will suggest to you, you need to see an experienced rhinoplasty surgeon in person to have a genuine and accurate assessment and recommendations.  In a general sense however, there are definitely techniques that can aesthetically reduce your over projection, correct your tip asymmetry, and correct your septal irregularities. Best wishes to you as you pursue your evaluation.

Very thin skin, septum deviated, pointed tip and one side looks different from the other side. What do you recommend? (photos)

Answers (8)

Answer: Very thin skin, septum deviated, pointed tip and one side looks different from the other side

Answer: Very thin skin, septum deviated, pointed tip and one side looks different from the other side

Answer: Rhinoplasty

Answer: Rhinoplasty

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Everything you need to know about Rhinoplasty

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Very thin skin, septum deviated, pointed tip and one side looks different from the other side. What do you recommend? (photos)

Answers (8)

Answer: Very thin skin, septum deviated, pointed tip and one side looks different from the other side

Answer: Very thin skin, septum deviated, pointed tip and one side looks different from the other side

Answer: Rhinoplasty

Answer: Rhinoplasty

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.