Septorhinoplasty: What needs to be done? (Photos)

How would you fix my nose? Is it just my nose that's the problem? Surgical? Under local or general? Non-surgical or less invasive options?

Doctor Answers 10

No septoplasty indicated

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your case has no indication of septoplasty, septoplasty is to improve the function of breathing against nasal obstruction when it is due to a inner or deep septum deviation.

You have nasal assymmetry, not a deviation, and this has no correction; every human being has an assymmetry on the face and nose, and actually is not a deformity.

Yours is a basic reduction and feminization rhinoplasty, and if you wish a refined look I recommend treating the bulbous tip by means of reduction, plication and domal plasties.


Spain Plastic Surgeon

Septorhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Big Don,

  • You are a great candidate for rhinoplasty.  Rhinoplasty can make your look nose smaller and thinner and give you an overall more proportionate nose. My recommendation is to have rhinoplasty done under general anesthesia due to patient safety. 
  • It is best to have an in-person consultation so we can examine you and show you morphs of what is possible
  • When you are ready, please visit a rhinoplasty specialist who can address your concerns and answer your questions.

Best regards,

Nima Shemirani


Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Surgical Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A surgical rhinoplasty is a powerful procedure that adds, removes, or re-positions tissue in the nose for better aesthetics - often completely reshaping the nose. This often involves removing dorsal humps, lifting drooping tips, and narrowing the nose. 

Base on your photos, surgical tip refinement will offer you a smaller, more defined nasal tip. In addition you would benefit from a hump reduction and narrowing of the mid vault. This would be done most comfortably under general anesthesia (while you are asleep) as an day surgery.

Each nose is different, however, and so there will be slight variations in the technique. In addition, the thickness of the nose skin can affect the overall result.

See the link below for more information.

Non-surgical options will not be of much benefit. 

A detailed examination will help delineate the best treatment. Consultation with a plastic surgeon certified by the American Board of Plastic Surgery would be the next best step. 

Septorhinoplasty: What needs to be done?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Answer this question

  A septoplasty is performed in the back of the nose to improve airflow dynamics and is only performed for medical necessity.  A septoplasty will not change the shape of  the nose.  A rhinoplasty is performed for cosmetic purposes to change the shape of the nose, such as reduction of the bulbous tip, narrowing the bridge, and shaving down the dorsal hump.  Both a septoplasty and a rhinoplasty can be performed together, but plan on paying for the cosmetic component yourself.  The functional component can be billed to your medical insurance, once medical necessity has been documented and preauthorization has occurred.   In our practice, both procedures are performed under general anesthesia  by a board certified physician anesthesiologist as an outpatient surgical procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

What Needs to be done with my nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi and thanks for your question and photos.  You have a bulbous tip with an overall wide nose and a wide alar base.  You have a minor dorsal hump (bump on the bridge) and a tip that could stand to be rotated up slightly.  I would do your surgery through an open approach and remove some of the bulky, excess tip cartilages and put sutures in to narrow your tip.  I would support and rotate your tip by attaching it to the end of your septum.  I would shave down the dorsal hump and narrow your nostrils with an alar base excision. Good luck.

Jonathan Pontell, MD, FACS
Philadelphia Facial Plastic Surgeon
4.8 out of 5 stars 113 reviews

Rhinoplasty and septoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. You may also benefit from a conservative dorsal hump reduction.  If you are having breathing issues, spreader grafts and a septoplasty may help and can also help straighten your nose.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 reviews

Nose Flaws Reduction and Pain

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your nose is wide close to your eyes, ideal or slightly narrow in the center and wide in the tip area. You have a small hump, your tip is under-projected and the column between the nostrils (the columella) is retracted. Your nostrils are too short they will look more pleasing if they are made slightly longer. The biggest challenge is the skin around the tip which seems to be thick and this makes achieving an option definition to the nose tip difficult and requires special maneuvers and sufficient experience to produce enough improvement to make the operation worthwhile.  

Bahman Guyuron, MD
Cleveland Plastic Surgeon
4.7 out of 5 stars 23 reviews

Septorhinoplasty: What needs to be done?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Of course the best decisions would be made after an in person consultation with a Board Certified Plastic Surgeon.  Certainly, we can consider some options based solely on the pictures.   Without having the opportunity to discuss with you what bothers you the most and what view bothers you the most.

Clearly in frontal view your tip is off to the right and the tip is quite bulbous.  This is also seen in the profile view.  Rhinoplasty under general anesthesia, considerably more aesthetic tip could be accomplished in both views.  Your nose could be made more straight as well.  There is a very small dorsal hump that could be corrected at the time of your rhinoplasty. 

Thomas Hubbard, MD, FACS
Virginia Beach Plastic Surgeon
4.7 out of 5 stars 41 reviews

Septorhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It really depends on what are the things that bother you about your nose and what you would like to have changed or altered. A reduction rhinoplasty would allow us to modify your nose making it a bit smaller and refining it. This can be done with local or general anaesthesia and that is something that varies from surgeon to surgeon. Less invasive procedures will not give you any long lasting effects.

Andres Gantous, MD
Toronto Facial Plastic Surgeon
4.9 out of 5 stars 28 reviews

Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You would have to be seen in person and your symptoms reviewed and concerns about your nose.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.