Can my nose be deprojected, with dorsal hump removal and bridge narrowing and will I need tip refinement? (Photo)

Based on your photos it appears that you would be a good candidate for rhinoplasty, such as the example in the link below. Your rhinoplasty would require:Deprojection of tipHump reductionNarrowing of bridgeNarrowing of tip

You appear to have thin skin, and a large, somewhat masculine nasal appearance. Tip deprojection, rotation, along with nasal shortening, and closure of your "open-roof-deformity" are all issues that may be addressed. Goals may be to obtain a smaller, less distracting, and more feminine nasal appearance.Your thin skin may be more prone to show post-rhinoplasty irregularities, so ensure you are completely confident with your choice of surgeons before moving forward.Wishing you all the best, and hope this helps you.Dr Joseph

See the "Web reference" link, just below my response. I made a couple of computer morphs of your nose, and animations of the morphs, to show the changes that are possible for your nose in truly expert hands.The deprojection that I simulated is a little more than three and one-half millimeters. There is also an image that shows the new nose with the *outline* of the old nose superimposed, so you can see the difference. Your nose requires a significant deprojection, like the woman in the short attached video above.Another point: yes, the bones need to be narrowed where they create a flat spot on your bridge, and yes, the tip cartilages are broad and need to be narrowed and refined, but your tip absolutely needs to be elevated, as I showed in both morphs. When a nose is de-projected, it usually looks longer, and your nose is not short to begin with. If a primary focus of the operation is not to elevate the tip, you'll be looking for a revision later.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'll change, and by how much he'll change them -- so you know whether it's 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.

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. Cartilage grafts may also be used to help improve tip refinement.
I completely agree with your assessment of your overly projected nasal tip:  You may also benefit from de-projecting your nasal tip and a dorsal hump reduction. The most important aspect is
to find a surgeon you are comfortable with. With good surgical technique, you
could have an outstanding result.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

After reviewing your photos, I believe that your nose would benefit from tip deprojection and refinement, bridge refinement and building up the area between your eyes, known as the radix.  I recommend an in-office consultation with a Board-Certified plastic surgeon who will thoroughly examine your nose, create a simulation based on what your nose could look like after surgery, and develop the perfect plan to achieve balance and symmetry.

I would recommend computer morphing of your nose.  That will show you how decreasing the projection of the nose will influence your profile.  From what I can see, you need to address the bones the middle of the and the tip with deprojection.  Best Wishes!!

 A closed rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose 3-4 mm, narrowing the bridge and refining the nasal tip. It's also important to reduce the hourglass appearance on the three-quarter profile which is accomplished with small spreader grafts placed underneath the concave upper lateral cartilages.  The flat spot on the top of the bridge can be removed along with the dorsal hump and refinement of the tip. All this can be accomplished with the incisions placed on the inside of the nose  and without any painful packing placed on the inside of the nose. This is a very difficult rhinoplasty, so choose your surgeon very wisely based on extensive experience.

Hi there, Thank you for your photos and questions. As other doctors before me, I do agree with you that your  nasal tip is over projected in these photos.I wanted to suggest a photo simulation. did you already do a photo simulation? I think that might be helpful for you to communicate with your doctor. I wonder if your doctor is thinking that when you augment your radix (the very top part of your bridge where the nose starts) would help balance the nose and the deprojection of the nasal tip would be less than initially apparent.Hope this suggestion is helpful.G

Hi ACL2016,  From your fotos I think your nose is very overprojected and  this ca definitely be improved.  The goal would be to lower the bridge of the nose and in doibg so narrow it to correct the flat part.  A cartilage graft may also be added at the radix, upper part of the nos above flat spot, because the goal is to give you a straight bridge that has been lowered. This can be achieved by lowering the overprojected part and raising the deep radix.  Th decision for the graft would be made after lowering the rest of the bridge.  The tip of the nose will also be made smaller.  During your consultation the procedure should be explained in as much detail as you want and need to understand the outcome. It definitely needs to be lowered more than 1-2mm.You have time to visit your surgeon again and be sure you both agree on the outcome.

Dear ACL2016, Your nose can be made beautiful to balance well with your facial features in the hands of an expert surgeon. If you feel that you are still concerned about your results or you and your surgeon are not on the same page then I would suggest having the surgeon perform digital imaging on you so you can see the proposed results and make sure you are on the same page. Then review your surgeons before and after photographs to ensure that he/she can provide the proposed results. In simple terms your nose needs, de-projection of the tip, reducing of the dorsal hump, and narrowing of the bridge and tip. These refinements should provide a natural looking rhinoplasty to balance your facial aesthetics. See some examples of similar looking noses in the link below and video above. Best regards, Michael V. Elam, M.D.