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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"He is a perfectionist and will honestly give you your best nose. "

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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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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
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Questioner: Can I Have a Tip Refinement Instead of Full Rhinoplasty?
(Questioner submitted photos)

Dr. Denenberg's answer: Probably a tip refinement wouldn't be best for your nose
It's only the rarest of cases where you can work *only* on the tip. Changing the tip's appearance also changes what we think of the other parts of the nose, and they almost always have to be adjusted so the nose matches aesthetically. See my "Web reference" link for a morph of what changes I see for your nose.

Besides the strong tip cartilages, the bridge of your nose is strong in its forward projection away from the face, particularly at the top of the nose, where the nose begins just below the eyebrows. In my morph, I reduced the strength of your nose up there, reduced the width of the tip. Then, I moved the tip a little closer to your face as well, because that's a change that often happens when we're narrowing a tip. And I elevated the tip a small amount, so it doesn't cover your upper lip as much on the frontal view. Then I tucked up the columella, which is the part of the nose between the left nostril and the right nostril. That part can be brought up a small amount, decreasing the amount of the inside of your nose that is visible from the profile view.

The doctor you consider using for your surgery should be able to put together for you all of the aesthetic areas that you notice, and show you how changing those areas have implications for the *rest* of the nose.

Link to this question on RealSelf.com


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