Dr. Steven Denenberg's facial plastic surgery before and afters: Rhinoplasty, large tip noses #11

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The frontal view is always the hardest to evaluate, but we'll try. Look at the two white dots in the tip of the nose. They are reflections from the flashes, just as there are two white dots in each of her eyes. Now compare the position of those dots with the position of her nostrils in the before and after photos. You'll find that the dots are higher in the after picture, indicating that I succeeded in elevating the tip of her nose.

It's harder to tell what was done to the dorsum from this view, but check out the two vertical parallel white stripes in the dorsum in her after picture. They are more even and uniform than the stripes in her before picture, indicating that her dorsum was narrowed and straightened. See what you can tell if you know what clues to look for?

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All views of this rhinoplasty patient:

rhinoplasty 1: Right oblique	rhinoplasty 2: Right profile	rhinoplasty 3: Left oblique

rhinoplasty current: Frontal	rhinoplasty 5: Right oblique	rhinoplasty 6: Left profile

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Questioner: What Should Be Done on my Nose Technically? What Can Be my Expectations?
My nose make me sick. I dont know much about rhinoplasty but l definitely want to get one done this year. My columella is huge, the tip too. The tip is my what l hate the most and theres no really good front nose job. What should be done to my nose? What should l expect to hear from my surgeon? Can it be small. (Plus my nose is slighty droopy and has a small hump and stick out to much of my face)
(Questioner submitted photos)

Dr. Denenberg's answer: In expert hands, your nose can have a large change
Hi. The main change to make in your nose is to raise the tip. Then, we would want to bring the nose back closer to your face, as you mentioned, and take down the hump. See my "Web reference" link for a couple of morphs that I made to your photos. Then the tip of your nose can be narrowed, too.

You have a couple of caution areas about your rhinoplasty. First, when the hump is taken down, it's important that the upper part of your nose, just underneath your eyebrows, be taken down as well. If it's not, then you might look like a Roman statue: too strong where the nose meets the forehead.

The other caution is that your nose can have a large elevation of the tip. You want a surgeon who can accomplish that. If only a small elevation is made, you nose will still look distinctly too long after surgery, and you'll be looking for a revision. Bringing the tip of the nose up, and bringing it back closer to the face, are changes that require advanced techniques on the tip cartilages. You must be certain to see before and after photos of the doctor's other patients, showing changes like the ones you want for yourself, so you can know that your doctor has the skill to make those changes. You can't get that assurance with diplomas and certificates. Many of the revision operations that I perform are shortening noses and bringing them back closer to the face, after those changes were not made enough in the first operation.

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