Nuance in surgical technique is not the consideration here, rather it is surgical judgment. In other words, what maneuvers are required to achieve a nose that has the shape, projection, rotation, and profile that you desire. In my aesthetic judgment, I think your tip needs support. It is slightly droopy and would require the surgeon to reduce too much of the bridge of the nose to achieve a straight profile. I would also want to minimize the appearance of your arched nostrils. That said, what is most important is that you are satisfied with your new nose. Computer imaging might help you visualize the relative difference in these two approaches. Also, carefully examine their before and after photographs. If you are not entirely confident, seek a third consultation. Best Wishes
Droopy tip and bridge hump repair technique
There are many ways of achieving similar rhinoplasty results so I wouldn't be too concerned about what precise surgical technique is used for your surgery.
What is more important is the reliability of the surgeon's methods. I would review their before and after surgery results and make sure you like how the noses turn out in the long term (ideally about 1 year following surgery).
In the meantime you can read about droopy tip repair at my web reference link below.
Is there a right method or is it just what the surgeon prefers? Which method is best?
I am an advocate of closed rhinoplasty with minimal grafting, but there are many reasonable approaches. The key is to create a natural result.
Kenneth Hughes, MD
Los Angeles, CA
I would recommend all of the above maneuvers. Dorsal hump reduction, elevating the tip and osteotomies to reduce the base width. It may sound confusing but a phone conversation or office visit would clarify these issues. Seek a Craniofacial plastic surgeon who specializes in surgery of the face in your area.
The best rhinoplasty is the one that makes you happy. Look at actual noses like yours the surgeon has done and pick the surgeon bases on his results. Not technique.
Best Method for Rhinoplasty
There is not one best method to do a rhinoplasty. We frequently see examples of this when teaching during panel discussions at medical meetings; different surgeons show excellent results using different techniques on similar noses. Approaches will vary depending on the goals of each patient and the preferences of each surgeon.
Thank you for your photos and questions. That said I use digital photography to show patients changes that could be accomplished with the nose till they see the result they are looking for. That way the patient is fully informed about their procedure and I know exactly the result they are looking for
Rhinoplasty for droopy tip and dorsal hump removal
Rhinoplasty is very artistic and technical, so it is very difficult for the lay person to understand the nuances of techniques that are available to reshape the nose. It is best to visit a few surgeons who are very experienced in rhinoplasty, and for patients to have very specific goals upon what would you like to do with your nose such as lifting the tip, reducing the dorsal hump, and narrowing the bridge with osteotomies. Also important to release the depressor septi ligament, if present, which pulls the tip down with animation. For many examples and more information, please see the link and video below
Nose Reshaping | Rhinoplasty
Thank you for your question.
I don't think that the two recommendations are vastly different, just variations of a theme. The goals you recommend seem possible.
To be sure, see two or more board-certified plastic surgeons or board-certified ENT facial plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.
I hope this helps.