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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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Views of this rhinoplasty patient:

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She has a nice strong chin, which draws your attention away from the strength of the nose's projection.  Projection is one of the features of the nose that we can measure numerically, unlike most of the changes that have to do with words describing shapes or curves.  Her nose was deprojected by almost seven millimeters, more than one-fourth of an inch.

Compare her upper lip in the two photos.  A projecting nose will cause the upper lip to pull forward onto the bottom of the nose.  In the after picture, her upper lip has a more normal position because the nose is no longer projecting out too far; it's not yanking the upper lip forward anymore.


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"He takes the time to listen to your
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All views of this rhinoplasty patient:
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current: Left profile
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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: Is my nose tip broken?
As a child I had a bad fall on my nose. Ever since it has gradually got worse over the years. I have trouble breathing from my left nostril and I have a poor sense of smell. I can feel a split at the front of the tip. Also if I squeeze my nose tip it feels springy. I'm not sure if this is related, but I suffer with nose bleeds alot too
(Questioner submitted photos)

Dr. Denenberg's answer: Your nose isn't broken, but you must be very careful in selecting a surgeon.
The split and the springiness and the size of your tip are all related to the fact that the two cartilages that form the tip of your nose are fairly large and asymmetric. Your skin is thin, so it's easy to see, and even feel, the contour of those cartilages under the skin.

This all means that if you decide to have a rhinoplasty, you must be very, very careful about selecting the right surgeon. The vast majority of rhinoplasty surgeons do not have the skill and expertise to handle your tip cartilages, which cartilages pose a significant technical challenge.

When evaluating surgeons, you must insist on seeing before and after photos of their other patients. Look to see whether the doctor has been able to handle large tips like yours. If the photos only show profile views, like shaving off a hump, that's not good enough evidence for your situation. Generally, the three-quarter views show the tip cartilages best.

Link to this question on RealSelf.com