Told my Nose Was 'Inoperable'? (photo)

I recently had organised to have plastic surgery abroad, I was told it was possible to have my nose made less bulbous and more defined by email. After I flew there and on the day of the surgery the doctor took one look at me and told me it was impossible. He didn't discuss it at all, just said my skin was too thick and it could never be done. This was obviously devastating as I'd paid a deposit, flew across the world and spent months saving for the operation. Is this true?

Doctor Answers 14

The truth about a more "defined" nose...

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What you went through sounds horrible.  But that is the risk of long distance plastic surgery.  Iv always told all of my long distance patients that even after multiple Skype calls or phone calls or emails or reviews of their photos, ultimately I have to examine their nose and see and feel their nose before finalizing the rhinoplasty surgical plans.  With that said, Iv never had to drastically change the operative plan because I do insist of good photographs.  

Now based on your photos, your nose looks pretty small overall.  I can see your tip cartilage outlines at its inferior border and your skin does not look very think at all.  Perhaps a bit oily but not very thick.  You definitely could make the tip narrower and the bridge narrower as well.  But based on these pictures, which dont show the rest of your face, Id say you dont NEED a rhinoplasty.  But if I had better pictures then I could evaluate it better.  Regardless, you should be happy this plastic surgeon refused to operate on you and did the ethical thing if he thought he couldnt make your nose better rather than take the rest of your money and just put you through an unnecessary Rhinoplasty.  But even with think skin, nice improvements can be made.  He perhaps thought your nose is really pretty good and doesnt need surgery.  Finally, "defined or definition" is very subjective. 

Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 119 reviews

Rhinoplasty for nose with thick skin and bulbous tip

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When addressing a difficult rhinoplasty surgery, it is always best to obtain 3 consultations by experienced rhinoplasty surgeons. While it appears that there is thick sebaceous olive complected skin, there are some conservative refinements that can be obtained.  Careful and close monitoring and followup is critically important since you will most likely require some cortisone injections in the tip to remove the pollybeak deformity in the postoperative period.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Inoperable Nose and Bulbous Tip

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   Your cartilaginous framework of your tip can be made smaller without compromising your breathing despite the condition of your skin.  You could improve your tip.

Told my Nose Was 'Inoperable'?

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Bad picture, but it is possible that the skins can be thick, in this case, you can change your skin with cosmetic care, en then consult a surgeon. 

Maria Cristina Picon, MD
Argentina Plastic Surgeon

Candidate for Tip Refinement Surgery

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Fortunately, the plastic surgeon that you met was at least honest with the limitations of his abilities. There are surgeons who do have the experience and abilities to improve the shape of your nose. Do your research, ask other doctors in your area, ask friends and family to give you references to several good Plastic Surgeons. Multiple evaluations and consultations are important before deciding who to go with for surgery. Trust and confidence in your surgeon is essential! Hope this helps!

Thanks for your question and photos. Best of Luck!

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 177 reviews

Bulbous tip

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your tip can be reduced to a certain amount, and make it more not think it is a question of country, but of expertise of doctor performing surgery.

there are good surgeons everywhere, just did not find the good one. trust good doctor, ask asaps member in your area, american society of aesthetic plastic surgery.

Alberto Di Giuseppe, MBBS
London Plastic Surgeon

Told my Nose Was 'Inoperable'?

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Your story is all to frequently told here. Count yourself LUCKY that the doctor turned you down! Seek in USA evaluations to have a rhinoplasty. 

"Inoperable" Nose Candidate for Rhinoplasty

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Helena, I am sorry to hear about your situation. Looking at the photos provided, it appears that you would indeed benefit from a well-performed rhinoplasty procedure. Although thick skin can limit the amount of tip definition that is ultimately achieved, there is still some room for improvement. Seek out a qualified, board certified facial plastic surgeon to perform your surgery.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

Rhinoplasty Surgery

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Dear Helena, First of all you were flying in the wrong direction most patient's come from abroad to the United States for expertise in rhinoplasty surgery. I am sorry for this very unfortunate circumstance but this was a blessing in disguise if the surgeon was not competent enough to perform your procedure. I certainly hope you were given your deposit back as this is highly unprofessional. I perform surgery on patients from all over the United States and abroad and a full consultation process is done prior to any scheduled flights. I review before and after photographs, past surgical operative reports, computer live consultations, and many times an examination by another referring surgeon in their area. Stay in the United States and seek an expert here. While this was costly nothing is more costly then a poor rhinoplasty result. One of the reasons that as surgeons we enjoy the opportunity of answering questions via realself is the education that this gives to other patients seeking procedures. I am very sorry for your unfortunate circumstances however we appreciate the post as this may help another person not fall victim to similar circumstances. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews


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   I am sorry to hear about your regrettable experience.  I do not know to what your surgeon was referring but I could not disagree more.  If your surgeon felt that your nose was “inoperable” then you may have just dodged a bullet.  Your experience could have been worse if your surgeon elected to operate on your nose and didn’t have the skill, training or experience that is required for rhinoplasty surgery.  There is a measure of fortune in this experience in that you were able to return home with your health intact instead of a disastrous outcome. 

  As many of the other experts have chimed in, even thick-skinned noses can have improved definition, refinement and less bulbosity.  The most important point is to set appropriate expectations in the consultation, before the day of surgery.  

Hope this helps.

Christopher Kolstad, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 59 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.