Contemplating a rhinoplasty/septoplasty surgery and am looking for thoughts/suggestions! (Photo)

I like the tip of my nose, but dislike my side profile view (hump) and want it straight (not overly ski sloped...just straight). I worry about ending up with a droopy tip. Would I have to have tip work done for everything to look symmetrical? Would open or closed rhino be my best option? I'm concerned about my nose (front view) looking wide after hump is removed. I want MY nose (only straight from the side profile and better symmetry). I appreciate any positive and realistic feedback. Thanks!

Doctor Answers 14

Your evaluation and plan sound good to me.

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See the "Web reference" link, just below my response. I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands.

Besides lowering the bump, I brought your entire nose a teeny bit closer to your face. You'll also notice, in the animation, that I took care to lower the bridge up where it starts, just below your eyebrows. That area needs to be lowered, too, as I drew, or your profile might start to look like a Roman statue's where the profile line skids from the forehead right onto the nose, without the little dip there. Hope I explained that well enough.

I don't think you have to worry about having a droopy tip. Right now, your tip isn't too droopy. If care is taken with the tip during surgery, using techniques to protect the position of the tip, later drooping shouldn't be a problem. Some patients might even want a tip higher than what I drew.

While it's true that lowering a bump can make the frontal view look wider, if the bridge of the nose is narrowed during the operation, that's not a problem.

You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.

Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. Then, he must show you before and after photos to prove that he can actually accomplish what he draws on the computer.

Rhinoplasty candidate

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Dear Bettyx16, You have a very common nose that we see in my practice and the request for a natural looking rhinoplasty can be achieved in the hands of a skilled surgeon. During consultation the surgeon can discuss with you in detail your concerns. I.E. the nose will not look wider when the hump is removed as osteotomies are performed to bring the nasal bones back together. The dorsal hump will be reduced leaving you with a straight bridge and not a sloped over rotated nose. As far as technique used in your procedure it is best to choose your surgeon and then use the technique the surgeon is most comfortable with to provide you the desired nose you want. During your consultation have imaging performed to show you the proposed changes and to ensure you and your surgeon are on the same page. Once the desired nose is agreed upon review the surgeons before and after photographs of noses similar to yours to ensure natural looking rhinoplasty results. Then you can make an informed decision. See some examples of ethnic rhinoplasty in the link below and in the video above an example of imaging showing the proposed result and the patients actual result so you can see how close in proximity these are. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 214 reviews

Contemplating Rhinoplasty/Septoplasty

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If you want to straighten your nose and remove your hump a full rhinoplasty will be necessary. It appears this can be accomplished with a closed procedure. Hump removal will not increase the width of your nose and will give you a well defined but feminine appearance if it is done by an experienced specialist. Look at various websites and consult with surgeons whose results you like. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Contemplating a rhinoplasty/septoplasty surgery and am looking for thoughts/suggestions!

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The appearance of your nose can be improved with an artistically performed rhinoplasty-septoplasty. What would be the best option and exact procedure would depend on an examination and discussion about desired outcome. 
Excellent cosmetic results can be achieved with both closed and open techniques. There is not a best way to perform the procedure. Individual surgeons have their own preferences of how to produce the best results in their hands. What is more important than whether a closed or open approach is utilized is the experience and artistry of the plastic surgeon and your comfort level and confidence in that individual.
 Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you exactly what to do and how to do it based on two dimensional photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon with extensive rhinoplasty experience certified by the American Board of Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. Additional information about the procedure will help you decide if it is a procedure that you want to pursue. 
Robert Singer, MD FACS
La Jolla, California


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Hi Betty,Thanks for your question. Based on the provided photo, I don't see any reason why your goals could not be accomplished. We can certainly address the hump without addressing the tip. Without further evaluation, determining the exact technique that would be most appropriate in your case is difficult, so I'm sorry not to be able to answer that aspect of your question.Please let us know if you have any other questions or concerns!

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 47 reviews

Contemplating a rhinoplasty/septoplasty surgery and am looking for thoughts/suggestions!

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In order to evaluate most accurately - all views of the nose are needed. From your profile view- you appear to be a good candidate for Rhinoplasty. Addressing only one element of the nose can disrupt a facial harmony. In order to achieve the best looking nose- all elements of the nose have to be addressed. I would curtly utilize a closed Rhinoplasty technique in a case like this. Seek an in person exam by a Board Certified PS with extensive experience in Rhinoplasty

Profile without tip

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The short answer to your question is yes, you can have the profile adjusted without having tip surgery.

This can be done using a closed approach (no external incisions) and you will have to wear a splint for a week.  You may have bruising around the eyes.

Find a surgeon with whom you communicate well and who you trust.  You can get more detail during your initial consultation.  

All the best to you!

Open rhinoplasty considerations

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In my opinion - an open rhinoplasty with dorsal hump reduction and tip-plasty would help you achieve your aesthetic goals. The tip-plasty portion of the procedure will restore tip support.

Rhinoplasty and septoplasty

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A closed rhinoplasty procedure can accomplish shaving down the dorsal hump which is composed of both bone and cartilage by making all of the incisions on the inside of the nose.  A full set of photographs are required to make any determination about the nasal tip, since it is a 3-dimensional structure.  It is possible to leave the dorsal profile straight and not ski sloped.  Once the dorsal hump has been removed, osteotomies are required to be placed in the nasal bones to narrow bridge line and close the open roof created from the  hump removal.  A droopy tip should not occur from the hump removal.  Rhinoplasty is a difficult endeavor, so choose your surgeon very wisely based on extensive experience.  A septoplasty is performed in the back of the nose when there is twisted bone and cartilage blocking airflow, and is performed only for medical necessity. For more information and many examples, please see link and the video below

Conservative rhinoplasty

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Hello and thank you for your question. Based on your photograph, you may benefit from a conservative dorsal hump reduction.  Your breathing could be improved at the same time, if you are having problems breathing.  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

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.