I cant decide if its just the bump on the bridge, the length, the width or the bulbous tip? (Photo)

I have a deviated septum and will get it fixed. I also wanted to get rid of the bump in my bridge. I think I also need to make it thinner in general. Can I get an ENT to do this?Do you have any recommendations on what I should do to have a more appealing nose?

Doctor Answers 8

Recommendation to address this issue

Thank you for your inquiry!

As an ENT and a plastic/reconstructive surgeon, I can tell you that you seem to be a good candidate for a corrective rhinoplasty dealing with the aspects of your nose that you dislike while complementing your facial features and providing you with a natural look.

However, without a physical examination it is not possible to provide you with specific details. I highly recommend that you schedule a consultation with a well-experienced surgeon.

It is important to mention that the finest cosmetic results in any particular case are based on a variety of factors, including: the unique anatomy of the patient, realistic expectations, a well-informed and detailed discussion with your plastic surgeon concerning the best options for you especially covering a deep understanding of the pros and cons of any given choice you will adopt.

Please keep in mind that following the advice from a surgeon online who offers to tell you what to do without a physical examination covering the nature and the status of the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative solution would not be in your best interest. With that in mind, it is the safest and for your best interest to find a plastic surgeon with solid experience and certified by the American Board of Plastic Surgery who is ideally a member of the American Society of Plastic Surgeons that you will trust and be comfortable with. You should discuss your concerns with that surgeon in person.

Good luck!!!

Ali Sajjadian, MD FACS

Orange County Plastic Surgeon
5.0 out of 5 stars 195 reviews

Rhinoplasty recommendation

You will need to see a Facial plastic surgeon or a plastic surgeon for the aesthetic portion.  Some of these specialists do both the functional and aesthetic procedures.  I would recommend dorsal hump reduction and width reduction, tip refinement by removing cartilage and tip elevation.   Best wishes!!

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Aeshetic Nasal Surgery and Functional Surgery

Septal surgery is common, but it is complex.  If you have a combination of airway problems and aesthetic problems you need to find a surgeon who is comfortable with both aspects of rhinoplasty.  The way to decide if you want any surgeon who does this type of work is to look at their results, their experience, and make sure your aesthetic eye agrees with theirs.  I would choose a either a plastic surgeon or facial plastic surgeon for this type of work.

Jay Calvert, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 50 reviews

Functional and cosmetic nasal surgery

The functional component and the cosmetic component of the nose are 2 completely separate issues.  Look for a ENT/ facial plastic surgeon who performs hundreds of  septoplasty/rhinoplasty procedures a year who can address both functional and cosmetic components of your nose, and is board certified in facial plastic surgery and in the ear nose and throat surgery. For more information and our photo gallery, please see the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

I cant decide if its just the bump on the bridge, the length, the width or the bulbous tip?

I would deproject the nose and reduce the tip while refining the bridge. 

Find a board certified plastic surgeon who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Problem with the Bump, Width, and Length of Nose

All of these unwanted characteristics should be changed when having septoplasty surgery. When selecting a surgeon you should choose a specialist not only on the basis of board certification but also experience. Some ENT surgeons are excellent cosmetic nasal surgeons.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

It can be done at the same time

Regarding the cosmetic concerns, the nose is in general wide and long.  These are certainly improvable issues.  Speak to your ENT surgeon about their level of comfort in performing the rhinoplasty portion of the nasal surgery.  If the surgeon is not comfortable, they can refer you to a qualified and experienced nasal surgeon who is.  Please note that they cosmetic portion of the procedure will not be covered by insurance.

John Frodel, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 1 review

ENT/Facial Cosmetic Surgeon

Hi  there, great question.
In North America, Otolaryngologist - head and Neck Surgeons (ENT) are one of the few specialties that operate solely above the shoulders (100% of the time). A part of our training is in facial cosmetic and reconstructive surgery. In fact, a number (such as myself) of Otolaryngogists do extra training in facial cosmetic and reconstructive surgery. A nice benefit of having an ENT do the procedure in this situation is that both your breathing and cosmetics can be addressed. Now, this sounds easier said then done. there is a very find line between breathing well and having a nice looking nose. What I mean by this, is that often times people who have a "wide" nose and want it narrowed end up reducing their ability to breath. Doesn't take a surgeon to know that narrowing the opening of your nose will make less air enter it! But I digress....My point is, when you are going for both function (breathing) and form (cosmetics) you need to have a surgeon who has knowledge and is willing to tackle both. 
Looking at your nose, i agree that you have a few things that could improve both your front view and your side view. Starting with the front, you do have a wide nose. When we view the nose this way, we look at it in thirds, upper, middle and lower. To me, i see wideness primarily in the middle and lower third of your nose (the upper may be wide, but difficult from the picture). Treating this area is a bit more involved and has a higher risk of poor breathing.  Nevertheless, if you had these area narrowed, had your nasal valve tightened (this prevents your nose from collapsing when you breath in) and a septoplasty, i do think you'd have a nice result on the front view.  
From the side, i notice two things. You seem to have a long (projected nose) and the fullness (or hump) in the middle. Again, these two things can be improved and you face will have more symmetry from the side. Here in ottawa, Canada we have three ENT - Facial Cosmetic Surgeons that work together, so we are used to these types of issues. 
My recommendation is to do some research and find a surgeon that is comfortable achieving the goals you are interested in. Breathing and cosmetics. 

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 17 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.