Would a tip refinement surgery help my droopy bulbous nose? (Photo)

Thank you for your question. You are an excellent candidate for rhinoplasty. I agree with your assessment and think it is one of the most beautifying surgeries that we do as plastic surgeons. In your case, I would use alar contour grafting as well as alar base excisions to reduce the flare and prominence of your nostrils. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Hello and thank you for your question. Just to clarify, if you're interested in improving your nasal tip, this is a common complaint and something that can definitely be addressed with surgery. Many people complain that their nasal tip is too "bulbous" or "boxy" and that they would like it to be smaller, cuter, more defined, or more feminine. An open septorhinoplasty can best address the entire nose, and is particularly effective for addressing a bulbous, boxy, or asymmetric nasal tip- especially in the secondary/revision context, as in your case. It is also very effective for performing complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look.
Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery- and secondary/revision procedures are even more difficult. That said, I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.
Regarding the anesthesia, my personal preference is similar to most- full general anesthesia to assure the most controlled environment and facilitate the best possible aesthetic results for such a complex procedure. Everything ultimately comes down to surgeon and patient preference, so always have the conversation with your surgeon so you both know exactly what to expect, and so you both feel comfortable with how the procedure will be performed prior to proceeding.
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos provided. I recommend for you to come see me or another plastic surgeon comfortable with revision/secondary rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Your questions would be best addressed during an in-person consultation with a surgeon who specializes in rhinoplasty or particularly "revision rhinoplasty". An experienced surgeon will be able to address your questions after a physical examination of the nasal anatomy and a conversation of what your ultimate goals and expectations are.

Undergoing any surgical procedure requires careful attention to detail and consideration for different options. Consider obtaining several opinions before moving forward with any given procedure. Always trust your face to a board-certified facial plastic surgeon or a board-certified plastic surgeon with very extensive rhinoplasty or "revision rhinoplasty" experience.

Over time the appearance of the nose can certainly change. The surgical maneuvers to get your nose looking the way you may have wanted it to 20 years ago may have created some issues as you have aged. You have a few issues that I can see. You have what we call columella-alar disproportionation which is retraction of the ala. You have a very small tip lobule which is why your nostrils appear to be long. There are several surgical maneuvers that can be performed in order to remedy the issues that you are having with the appearance of your nose. Cost will in part be related to the need for grafts but revision rhinoplasty generally starts at $15K in experienced hands.

Hello! Thank you for your question.
As far as I can see from your photo. You have a hanging columella and Bulbous tip.For get rid of this image I recommend you revision Rhinoplasty surgery.It would be more convenient to decide with face-to-face consultation. Best regards!

In a reversion rhinoplasty nasal profile can be enhanced including the nostrils or tip. It is better for you to consult with a facial plastic surgeon who can examine you and discuss the surgical procedure and the post op recovery process.

It appears that secondary rhinoplasty, mostly tip improvement, would be a good procedure for you. You may also consider small chin augmentation with implant to create better balance. In person consultation with a board certified plastic surgeon, expert in rhinoplasty, is recommended. Good luck.

Interesting set of photos. The last few frontals show your tip as being quite wide, but the third posted photo doesn't really show it. But yes, the tip and nostrils can be addressed in a revision. A better set of photos would help, though, in figuring out what else might need to be adjusted so the nose looks natural after surgery.
How *much* to narrow the tip, or perhaps change the forward projection, 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 better just 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 really 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 the surgeon has that information and judgment best.)

Finally, 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.

It is not uncommon for the tip of the nose to drop down after rhinoplasty. Fortunately it’s a pretty straightforward thing to current. It can be done as a closed rhinoplasty

My suggestion would be carefully planned and skillfully accomplished secondary (mostly tip) rhinoplasty. Would bring top of the nose down a bit to create a visible supratip break to visibly separate tip from top of nose. The tip should be more distinct, and would slightly thin tip skin to improve tip definition and shape tip cartilages for a slightly more angular delicate feminine allure. Would also raise midline columella for less nostril show and lift upper lip for vertical shortening and more upper lip fullness as part of the procedure if you agree.