Female w/ Boxy/Bulbous Nose (Dr. Oakley Smith) - Canada

Hi team, Long time lurker and first time poster....

Hi team,

Long time lurker and first time poster. I'll be having rhinoplasty with Dr Smith in T-minus 3 weeks. I chose Dr Smith after a consultation- he was thoughtful and informative- particularly on realistic expectations.

I especially appreciate the latter- I had a consultation years earlier with a surgeon who had asked me what "kind" of nose I wanted. After visiting with Dr Smith, I realize a) such a nose is probably not possible for me and b) I needed a nose to suit my face. I trust that he will do to the best of his ability to improve my nose.

My nose now is bulbous and large with a small hump on the sides of my bridge. After Dr Smith checked me out, he said my nose was structurally "interesting" and that it would most likely be resistant to a lot of change. Hopes for this procedure:
- narrow tip (triangular instead of boxy)
- sloped profile
- remove bump

I still can't believe I'm going through with this. I'm so excited. It's an awkward topic with my parents but for the most part they're cool with it. My friends have been very supportive.

Post Op Days + Photos

Hi gang,

Had my surgery- it all went well. Dr Smith’s team was super nice and the nurse took great care of me afterwards. I hung out in post-op care for an hour, then switched rooms to hang with my parents for another hour.

I was amazed to wake up and breathe through my nose- great feeling! That would be the stents.

I iced on and off yesterday (2 minutes every 20) before an early bedtime. I was quite comfortable but woke up every few hours to try to pee (which is the only drag- you totally can’t!) and clean my nose. I sleep in a recliner with a U-shaped traveler’s pillow.

Bruising is mostly under my eyes but hidden by my cast. A TON of swelling between my eyes. I look like an Avatar.

- No pain (I’m keeping on top my meds)
- Less bruising than I thought (more bruising occurs later on apparently)
- Can breathe through my nose!
- Triangular shape from bottom view

- Difficulty urinating
- Gauze tape is irritating my cheeks

I know I’m still swollen and squishy but I already love the shape Dr Smith has given me! More pics to come... for now, icing and napping. I’m using peas and this awesome ice-mask thing.

Post Op Day 5 (Quick Update)

Swelling is migrating down my face into my cheeks (left my forehead!). My bruising is way less and turning "highlighter yellow.”

- Less swelling
- Bruising fading
- Taking less pain meds (switched to Tylenol)

- Nose is stuffy and a bit stingy inside (freezing wearing off?)
- Nose feeling itchy under cast

I bonked myself on the nose during the night and oh ma god did that hurt! Ended up taking an oxycodone for that, but otherwise all seems pretty well! I’m not looking forward to getting my stents out on Thursday as I assume that’ll really sting/induce more swelling. Front teeth are still bit numb but I’m starting to feel a bit more “normal” now.

In the meantime I’m working from home and watching Netflix.

Cast off!

Check out the pics. Guys, I am NOT DISCOURAGED. I know my nose looks massive right now and I’m still AOK with it (also seems to look worse in photos). My nostrils are way smaller/rounder than they used to be and my profile is a little softer. I also have no more bump on the side of my bridge. I’m sure you guys understand that for one who obsesses over their nose, a little change makes a huge difference.

Removing the stents was unpleasant but not awful. Same with stitches- a lot of eye-watering but it was over quick.

I was told to press my nasal bones together for 2 minutes every 2 hours for a week. This is to help keep the bridge narrow as swelling is pushing the bones apart. It’s a little gross to feel how squishy my nose is, and when I’m finished, there are deep depressions of my fingers.

Bruises fading, a little smudge on my eyelids left and a bit of under eye.

I’m still glad I did this and look forward for the swelling to go down. I see Dr Smith again in 3 months, otherwise I’m pretty good to go. I’m going to continue sleeping in a recliner this week and have started popping Advil like candy.

Sidenote: my skin is gross- equally dry and greasy. Enjoy the close ups!

Thanks for the nice comments guys!

Really appreciate the comments here- nice community! Nose seems to be about the same but here’s a pic anyway! I’ll do more later this week.

I found this thread super helpful regarding post cast-removal blues: https://www.realself.com/question/swelling-changing-shape-nose-after-cast-removal-rhinoplasty#gref

Basically, your nose will go through every shape in the world before it settles back down. I had a moment of “NOOOOO MY TRIANGLE NOSE IS MELTING” the other day but it’s all part of the process.

- No more dry mouth! Breathing easy through my nose
- Bruises almost gone
- Exfoliated skin... feel like a new woman
- Nose slope is still good

- Sneezing like crazy... anyone else experience this?
- I think sleeping on my side (I guess I roll around) might contribute to swelling to one side over another some days
- I miss my oxy (joke! but not really)

So yeah! This was a quick update, I’m hoping to go on a week to week basis to hopefully see some change in photos. I realize it’s kinda hard to compare based on lighting and phone vs camera.

Thanks team!

Comparisons- profile and frontal

I love when people post their before/afters so I thought I make these two. Before and 13 days post-op. Decided to go B/W in the profile comparison to highlight contrast.

Updates: melting triangle/sneezing/two week in review


So as you can see my nice symmetrical triangle appears to be melting a bit. You can also see a bit of a leftover dissolvable stitch in one nostril, and a white bump on my columella. Apparently it’s normal to have that irritation from stitches and should go away on its own. I’ll be worried if it’s still there in 3 months, or gets bigger.

And same with my melty tip! It’s looking asymmetrical these days, oh well. I’m wondering if me sleeping on my side contributes to the unevenness? This nose is still an improvement from my old nose though! On one hand, I want a nice long summer. On the other.. I want to fast forward a few months to see what shape my nose is in.

I did find my nose appeared a little more swollen today- I started sleeping horizontal and also enjoyed some salty popcorn last night. May or may not have contributed.

You can see the impressions on my nose from me pressing my bridge together. Tip feels super hard, not nearly as malleable as my bridge. After today I leave my nose alone- no more 2 minute pressing exercises.

Theory of why I sneeze so much now: doc cut my nose hair! I have no filter!

Still cleaning my nose with a Q-tip and Bactine although I probably don’t need to. Behind my front teeth it’s still a little numb. Still popping Advil.

For those of you about to do surgery- I guess I can only speak for those going with Dr Smith... but boy, you have nothing to worry about! First week post-surgery looks worse than it feels. Besides being a tad uncomfortable with swelling and sleeping upright, first week was a breeze. Second week with cast off was great. A couple of people tried to scare me with OH MY GOD YOU’RE GOING TO BE IN SO MUCH PAIN A NOSE JOB WILL BE AWFUL! I disagree 100%. If they had pain and a ton of discomfort I’m going to go ahead and guess it had to do with their choice of surgeon.

I’ve already warned my co workers my nose looks like it’s exploding off my face so hopefully no drama/staring when I return next week!


It’s been a long time since I updated, sorry. To be honest I’m more interested in long-term results so don’t feel particularly in need of tracking my nose every week. I’ve started exercises and feel my nose tends to look puffier afterwards and the next day- did some last night and felt a little more stuffy today. Actually, I feel like swelling in my tip might be migrating down to my columella... but it’s so hard to tell! By the end of most days, my nose appears narrower (I can even feel it more... squishy when I press my bridge) whereas when I wake up, it feels stiffer and more swollen. I’m still sneezing a lot but it’s calming down. I’m still loving the feel and look of my nose from all angles. To me, it’s a massive change. Yes, my nostrils are still uneven but I’m thinking maybe at the 3 month mark I’ll get a cortisone shot and see if my left side calms down... and if it doesn’t, I’m still happy I did this! Sorry for the delay in response guys! I’ll turn my email notifications on.. I know this community is a great tool for future nose jobbers but I guess if people actually respond! Thanks team!

Updates- exercise, upper lip, alar base reduction

Hi RealSelf! I see Dr Smith for my 3 month post-op appointment at the end of the month. In the meantime, here are some updates: - I’ve started exercising and do feel my nose swells (slightly) afterwards. I stick a nose plug on after I work out and find it seems to help (maybe only psychologically) - A wonderful side effect I’ve noticed is that my upper lip is a little fuller (puffy or swollen). Woo! I have generally thinner lips so I’m quite happy to deal with this part of the swelling for as long as I have to! When I spoke with Dr Smith the morning of surgery, he had mentioned he was going to make a call or not whether to do an alar base reduction. He ultimately decided not to, but said it’s a procedure that can actually be done at his office with little recovery. I’m content with my nose now, and maybe if the tip goes down an alar base reduction would help overall harmony, but I’ll leave that up to him. I only notice the asymmetries in my nose when I take pics for this website, to be honest! Otherwise I’m happy and feel my nose blends into my face more. I’m also not self conscience when it comes to speaking to people up close- I’m not worrying about the angle of my nose or whatever. One of my least favourites was the 3/4 angle, so I include a before/2 months post photo. Loving it. For the first time ever, I was tagged in a photo on Facebook I didn’t cringe at. I’m smiling, and my nose isn’t the focal point of my face (in my opinion). :) I’m curious to see what Dr Smith thinks.

Quick Update


Received a bunch of messages, have been a bit busy with school/work/life. In short- saw Dr. Smith for my 3-month post op which went well, got two injections into my nose to help with swelling/skin tightening (I think). Still very happy with my nose :) I’ll post photos next week!

3 Months Before/After Photos

Saw Dr. Smith for my 3 month post-op and had photos done- nice surprise as I thought this took place after one year.

Dr. Smith was pleased with the result and opted for two injections into the sides of my tip to help with either swelling, or tightening skin- both? I had my eyes closed and can’t say it hurt too much. My nose is still partially numb, so it felt less of a prick than a flu shot would. Apparently these shots can take awhile before any effects are noticeable. My mom seemed to think my tip looked less puffy a couple days after.

Dr. Smith told me he did as much work as possible while keeping my nose structurally sound, and I believe him. I have no doubt in my mind he was the best surgeon for the job. He also mentioned my septum was severely deviated and he straightened that out.

You’ll notice from the basal view (underneath) my nostrils are uneven but less than they were before. The only thing I care about is its general triangle shape and am quite happy with this result. Before I started researching rhinoplasty I assumed any surgeon could transform any nose into a perfect, symmetrical one, but I realize now it’s all about improvement. My nose was super asymmetrical pre-surgery, and less so post. I also recall Dr Smith noting my nose was a “structurally interesting” and stubborn- one that would be resistant to change.

My nose still feels harder in the mornings and tender- hurts if I accidentally bonk it. Still healing. But I also notice good things- drinking a glass where my bridge doesn’t press against the rim, standing directly under light and having my nose not stick out like a beacon, etc. etc. Lost a nice pair of sunglasses when they slipped off my sweet new slope so that was kind of unfortunate... but another reminder my nose changed for the better :)

I think these photos highlight changes great, but also are kind of unflattering. I mean this in the sense that in “real-life” I find my nose blends much more into my face than these photos might lead one to believe.

I actually completely forgot to ask about an alar base reduction (we got chatting) but I assume if it was a plan of action Dr. Smith would have brought it up. I might email his assistant and ask anyway as I don’t see him again until the winter. I’ll probably post photos or an update in a month or two, we’ll see!

Thank you for your comments, as always!

Toronto Facial Plastic Surgeon

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
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