25, female. What type of rhinoplasty would give me the best results? (Photos)

Question

I am desperate to get my nose done, it's been a problem since my teen years. I have turkic ancestry, so I don't want a barbie nose, but I'd like to do the following -lift the tip and prevent droop when I smile - straighten the nose, as it bends to the side slightly. I have to keep taking photos and videos from a specific angle/side to not get self-conscious. - smooth the bump slightly. That' being said, I think size-wise I'd only like a slightly smaller nose. What I'm freaked out about is I read online that rhinoplasties basically irreversibly sever your ligaments in your nose and this can cause stiffness down the line. Also I worry that with scarred tissue eventually my nose tip would droop. Is there a way to avoid these? Or is my nose so big, that the surgery would have to be rather invasive in order to correct it. Thanks! I've added images of my real side profile as well as edited side profiles to show what I'm aiming for.

Ali Riza Öreroglu, MD · Answer

Based on your goals, a conservative structural rhinoplasty would be worth considering. The procedure can address the slight deviation, refine the dorsal hump, and provide better support and rotation to the nasal tip to help prevent it from drooping when you smile.
I would focus on preserving your natural ethnic characteristics rather than creating an overly small or upturned nose. Structural support techniques using your own cartilage can help maintain long-term nasal tip stability and reduce the risk of future drooping.
The extent of surgery and the most appropriate technique would depend on a detailed assessment of your nasal anatomy, cartilage structure, skin thickness, and existing nasal support. My goal would be to achieve a naturally refined nose that complements your facial features while preserving your identity.

Gautham Ullas, FRCS (ORL-HNS), IBCFPRS, EBCFRS · Answer

Hi
Your rhinoplasty goals are actually what most surgeons hear commonly. Cutting the ligaments do not cause stiffness. It is the scarring and certain techniques (usually rib cartilage) that makes the nose stiffer. The tip coming down depends on the technique used. As a normal consequence of ageing, the tip does come down. 
Personally i think you are a good candidate for a rhinoplasty.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have an overprojected and droopy tip appearance, and this is associated with a small dorsal hump. Goals of rhinoplasty surgery may be to provide a tip lift, with tip deprojection, and hump removal, for a less distracting, and more feminine nasal appearance. Wishing you while moving forward. Sincerely, Dr Joseph

Bulent Cigsar, MD · Answer

Your goals&mdash;modestly lifting the tip, reducing its downward movement when smiling, improving straightness, and gently smoothing the bridge&mdash;may be achievable while preserving the character of your nose. Nose size alone does not determine how extensive surgery needs to be. Your edited profiles are useful for discussing preferences, although they cannot guarantee a surgical result.
Rhinoplasty does not inevitably destroy all nasal ligaments or lead to future drooping. Depending on the technique, supporting attachments may be preserved, released and repaired, or reinforced with sutures and cartilage grafts. Preservation techniques can be useful in selected patients, but they are not automatically the best choice for every nose.
Some firmness is common during healing and often softens over time. Lasting stiffness can occur, particularly with certain tip-support grafts, so balancing stability with flexibility is an important part of planning. Scar tissue does not inevitably cause the tip to droop, but no technique can eliminate all healing-related changes.
The drooping you notice when smiling needs assessment in motion, as both muscle activity and tip support can contribute. Straightening also requires frontal views and an internal examination of the septum and airway.
A consultation with a board-certified surgeon experienced in natural-looking rhinoplasty would help establish a conservative plan. Specifically discuss how they would preserve or reconstruct support, limit tip stiffness, and retain the features that reflect your identity.

Alexander Ovchinsky, MD · Answer

Thank you for your question. 
Based on the profile photos provided, there appears to be a dorsal hump and a droopy nasal tip with some excess projection. These features are commonly addressed with rhinoplasty, with the goal of creating a straighter, smoother profile and a more refined, supported tip while preserving your ethnic characteristics and avoiding an overly small or artificial appearance.

Your concerns about nasal stiffness, ligament support, and long-term tip drooping are understandable. Rhinoplasty does involve changes to some of the nasal supporting structures, but careful surgical technique and appropriate structural support can help preserve function and achieve a stable, natural-looking result. The extent of surgery depends on your underlying anatomy and the specific changes needed, rather than simply the size of your nose.

During consultation, we can discuss your goals in detail and use photographic simulations to explore realistic options while maintaining the overall ethnic character of your nose. The final plan would be tailored to your anatomy and priorities.

Steven M. Denenberg, MD · Answer

Your nose is quite long, and the tip projects strongly forward away from your face. You are a good candidate for a rhinoplasty. If it's done well, there are no long-term problems with ligaments or scar or the nose lengthening again. There are two main items you have to take care of. First, the changes your nose requires cannot be accomplished by the average rhinoplasty surgeon, and you need an expert to work on your nose. You must see the doctor's other before and after photos, so you can see if he's been able to accomplish for other people what you want for yourself. Second, getting to an accurate goal *before* surgery is crucial. You must have the doctor make morphs of your nose to show what he's planning for your review. If he changes the nose too much or too little on the morph, he can re-do the morph to fine-tune a goal for you. If you are just horrified by his vision, that'a a great clue to get out of there. If you describe in words to the surgeon what you want, and he describes in words what he plans to do, you have no idea at all what the nose will turn out like. Fine-tuning morphs is mandatory.

Randal Haworth, MD, FACS · Answer

Your goals â a smoother bridge, a straighter midline, and a tip that holds when you smile â are structural, not a request for a tiny âBarbieâ nose. Tip droop on smiling usually reflects weak tip support and the depressor septi; a dorsal bump is bone and cartilage. A modern structural rhinoplasty can address those layers while preserving support as much as anatomy allows; stiffness and late tip settling are risks to discuss, not inevitabilities. How much work is needed depends on what must change, not on fear of an oversized operation. An in-person exam with profile and base views, by a board-certified rhinoplasty surgeon, settles technique and scale.

Yasemin Aydinli, MD · Answer

From your profile photos, you have a hump on the bridge and a tip that sits low and drops further when you smile, which is usually due to a small muscle under the nose pulling the tip down. A natural rhinoplasty that keeps your character is very achievable: slightly reducing the hump, straightening the nose, supporting and lifting the tip with cartilage grafts and sutures, and releasing that muscle if needed. It is true that rhinoplasty changes the ligaments and support of the nose, but a well planned operation rebuilds tip support with grafts, and that is what prevents the tip from dropping later.

Zoran Potparic, MD · Answer

Based on these photos you are excellent candidate for a rhinoplasty. Your next step should be in person consultation with a board certified plastic surgeon with good reputation in rhinoplasty. Good luck.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

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

Best wishes and good luck.

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

25, female. What type of rhinoplasty would give me the best results? (Photos)

Answers (10)

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