Main concern is dorsal hump & function - are my goals realistic? (Photos)

Hi @alcg2017. Thank you for sending your photos. You would be an excellent candidate for a rhinoplasty. A dorsal hump can be shaved down and straightened while sustaining a natural profile. A rhinoplasty in my opinion is one of the most difficult procedures to perform. The skill, artistry, and technique of the surgeon will determine the outcome. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. I hope this was helpful!

In answer to your question, yes, it is possible to improve your breathing through your nose and to “deliver a natural straight nose that fits my face”. To achieve this we would perform an open septorhinoplasty. Because of the size of the dorsal hump, we might need to perform lateral osteotomies, after taking down the dorsal hump, in order to achieve the nasal shape you seek.

Yes, you are a fantastic rhinoplasty candidate with reasonable goals of surgery. Please find an experienced plastic surgeon ideally with 3D imaging technology.

You have that bump on the bridge. Also, though your nose is strong in its forward projection away from the face. If only the bump is taken down you'd probably think the nose is still too prominent in most views. So we would bring the new straight bridge and tip back closer to the face.
However, when you make those two changes -- lowering the bump and "de-projecting" the nose, it tends to make the nose *look* longer, as if the tip had dropped, so it's actually important to elevate the tip as well. Not so much to make it look upturned or ski-slopey, but just so you don't look at it afterwards and wonder why it now looks too long!
How *much* to elevate the tip, or deproject the nose, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

I'd love for you to see some excellent morphs of what could possibly be done with your nose. It might make you feel better about the possibilities and help you plan your ideal goal.
Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

Hello and thank you for your pictures. You are a great candidate for rhinoplasty. We can remove the hump, reduce the projection and make your nostrils smaller. This will give you a natural and more feminine look that wıll complıment your facıal features. Best wishes.

Hi alcg2017! Dr. Walter Joseph here from Beverly Hills, CA! Based on your photos, I think your goals are certainly realistic! A dorsal reduction can be performed (i.e. removing the "bump"), while still maintaining a straight bridge WITHOUT a ski sloped or scooped appearance. As for your tip, it would totally be up to you as to if you want any tip work done whatsoever. Some patients choose to preserve their tip while only addressing the dorsal hump, which is both reasonable and achievable! I will say however, that with a significant hump reduction, it is often necessary to bring in the nasal bones via nasal osteotomies, which would result in a likely narrower appearance of the bridge of the nose on the frontal view. A thorough in-person physical exam would be needed to determine if this would be necessary. I hope this helps!

In general, when you make changes on someone’s nasal profile, the front will change as well. Based on your profile, you may benefit from tip deprojection and rotation, without a scoop. Functional issues are commonly addressed. Best to consult with several reputable rhinoplasty specialists and to view computer imaging to ensure you are on the same page as your surgeon. Thank you. Dr Joseph

Thank you for your question. You are an excellent candidate for rhinoplasty. I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Most plastic surgeons like to perform lip lift procedures at a separate time. Best wishes to you

You are a great candidate for a conservative basic rhinoplasty. I would do this as a closed rhinoplasty. Your selection of the right surgeon is the most important factor in getting a nice result

Dear alcg2017,
it is hard to tell for sure without an examination.Based on your photos, you look like a great candidate for rhinoplasty. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery