From your description alone, tip refinement sounds reasonable, but pictures are very helpful in these evaluations.
Kenneth Hughes, MD
Los Angeles, CA
The short answer to your question is that yes it sounds like you would benefit from a limited tip rhinoplasty. That being said sometimes when the tip is refined and/or narrowed, the middle and upper third may appear wider or higher and some minor dorsal work may also be required. This is not an absolute but it is possible you may need that area of your nose treated as well. As far as the tip flaring when you smile, it is possible you might also need an alar base reduction where the nostrils are brought in slightly especially as the tip is made smaller. Good luck in your area.
The areas you are concerned about are
frequently improved with a tip plasty or a full rhinoplasty. Whether you should have the procedure
is a personal decision only you can make. Additional information about the
procedure will help you decide if it is a procedure that you want to pursue.
Following the advice from a surgeon on
this or any other website who proposes to tell you exactly what to do without seeing photos and without examining you, physically feeling the
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. I would suggest you find a plastic surgeon with extensive nasal
surgery experience who is certified by the American Board of Plastic Surgery
and ideally a member of the American Society for Aesthetic Plastic Surgery
(ASAPS) or a facial plastic surgeon (otolaryngologist) that you trust and are comfortable with.
You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
Without a photos, it is hard to say. All noses pull out a bit when people smile. That is normal. Best to be seen in person to determine what can be offered.
Tip rhinoplasty candidate
Most patients must undergo a full rhinoplasty, not a tip rhinoplasty. On a rare occasion a tip rhinoplasty can be performed, however it's important to make sure the remainder of the nose is within balance. The tip rhinoplasty procedure involves suture techniques to the lower lateral cartilages and sometimes cartilage removal if the tip cartilage is excessively wide and thick. For many examples, please see link below to our rhinoplasty photo Gallery
A tip-plasty operation refers to a rhinoplasty with the sole purpose for tip refinement, thus altering the shape of the lower lateral cartilages. Narrowing the nasal base requires separate incisions and can also be performed. I recommend seeking a consultation with a facial plastic surgeon to learn more.
From your description it sounds like your tip may be improved with a tip rhinoplasty with alar base reduction (nostril reduction), but really hard to say without photos or an in person consultation.
It is hard to say whether or not you would benefit from a tipplasty without seeing you or seeing photos of you. If you wish to send photos, you would receive more detailed information.
Tip plasty or full rhinoplasty?
It is impossible to answer this question without seeing photographs of what your nose looks like. I would need to see photos as well as an examination to give you a proper answer. Face forward and profile photos are preferred.
You would obviously need to be examined but if what you describe is the case, there certaily changes that could be made to narrow the base and/or tip. Be sure your surgeon demonstrates any proposed changes with computerized imaging so you understand the likely outcome.