Your question: Is this look achievable for me through rhinoplasty? Photo
This picture that I edited of what I want my nose to potentially look like is not the best example. I sketched it over with a paint app but it gives a very loose impression and poorly drawn of what I am looking for. Does this look possible to achieve? I am very serious about getting the rhinoplasty in the next couple of months.
Dr. Denenberg's answer: Yes, possible. But you need a little lesson in evaluating the profile.
See the Web reference link, just below my response. I made my own morph of your profile, and explained the reasons that your morph may not look as good as you want it to.
Actually, it's a lesson that all patients and plastic surgeons should review. In your after morph, your nose appears too long, because as your eye looks at the image, it sees where the tip of the nose is, but it's hard to see where the nose begins, up in front of your eyes. It almost looks as though the nose begins up at your forehead, and that gives the impression of a very long nose, or a Roman statue's profile.
Anyway, read the Web reference link, and hopefully I've explained the issues well enough there.
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.
I know you're not expert in using the morphing software, but when you made your modification, you had your profile line slip from your forehead right down onto the nose, like a Roman statue's profile:
When the nose does that, there is not a distinct spot where the nose seems to start, in front of your eyes, and it makes the nose look very long. We measure "length" of the nose from the tip of the nose up to where the nose begins. In the image above, the nose seems to begin way up at your forehead, and it looks long. Below, I showed the apparent length of your nose, along the black line with the arrows:
Now here's my proposed before and after for your nose:
You'll see that there is a distinct dip in the profile line in front of your eyes, where the nose now seems to start. So the nose looks much shorter, as illustrated by the shorter black line:
Here's an animation of those changes. Give it a couple seconds to load:
With your nose, it's very important that the operating surgeon understands these considerations very well.
In addition to the changes discussed above, I brought the tip of your nose back closer to your face, as you did in your morph, and I also elevated the tip a tiny amount. The tip seems to point up even in the before picture, but that's because your head is tilted up. Whenever you bring the tip of the nose back toward the face, and take down a hump, it makes the nose LOOK longer, so it's important to control the length, usually by elevating the tip a little bit.
Does this fit with what you have in mind for yourself?
2) Click here to comment on those changes, or to ask Dr. Denenberg a follow-up question.
3) Click here to see more rhinoplasty before and afters of patients with combinations of features to correct.
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Plain talk about picking a plastic surgeon for your first-time or revision rhinoplasty.
I do lots and lots of revision rhinoplasties; I'll try to give you some advice here, to maximize the chances that you'll be happy after surgery, and to minimize the chances you'll need a revision.
Important!! How to tell whether your consultation was acceptable:
Photos. If a surgeon doesn't show you before and after photographs, scratch him off of your list. Period. No exceptions. Deal-breaker.
You pick a surgeon primarily from his before and after photos. Diplomas, board certifications, hospital affiliations, academic appointment, and even reputation tell you nothing: a surgeon is never tested for his skill, his artistic eye, the quality of his outcomes, or even whether he cares that his patients are happy.
You must see photos of other patients who had some features similar to your nose. For example, if your nose has a wide and drooping tip, don't accept profile-only photos of patients who had a hump carved down. You can't see the width of the tip on a profile photo.
Revision nose operations are much more difficult than first-time operations, so if you are consulting a surgeon about a revision operation, you must see photos of his revision patients.
If you do see the surgeon's photos, but you don't love them, scratch him off your list. You want to use a surgeon whose work you like. Don't assume that he'll do great on you when he didn't do great on the other people.
Thought experiment: you are going to hire a portrait painter to paint your portrait. Would you really hire the painter if he wouldn't show you any of his other portraits?! No, it would never occur to you to hire him. Well, now you're going to hire a surgeon to change your nose, in the middle of your face, and you aren't going to insist on seeing examples of his work, proof that he knows what he's doing? Think about it. Teach your friends.
Communication. If the doctor treats you disrespectfully, scratch him off your list. If he won't patiently listen to what you want for your nose, same thing. How will he know how to make you happy if he won't hear what you want for your nose?
If he conducts the consultation from behind his desk and doesn't examine your nose, deal-breaker. If it's the nurse and not the surgeon who conducts the consultation, run away fastest. All due respect to the nurse, she doesn't know what's possible and what isn't. If the plan is to see the surgeon for the first time on the morning of surgery, deal-breaker. For sure.
Computer morphing. If the surgeon doesn't do computer morphing of your nose, scratch him off your list. The morphing is crucial, so the surgeon can prove to you that he understands exactly what your goals are. Also, if the surgeon recommends some changes that you hadn't thought of, you need to see the morphs, so you can see whether you like those changes.
Your intuition. If your gut tells you "no," don't use the surgeon. Don't ever use a surgeon only because you know him, or your kids know him, or he lives on your street, or your primary care doctor referred you to him, or he did your breasts, or your tonsils, or your wisdom teeth, or you saw his advertisement, or his awards.
I hear these stories all the time from my revision rhinoplasty patients. You must do your own evaluation of any surgeon you visit. And by "evaluation," again, we're talking mostly about seeing his photos and seeing how well he communicates with you. Don't bother checking the surgeon's licensure and board certification and hospital affiliations and all that; it'll just distract you from what's important.
Conclusion. The fact is, the great majority of plastic surgeons who perform rhinoplasty shouldn't be doing the operation. It's an incredibly difficult procedure, technically demanding, requiring experience, skill, judgment, an artistic eye, an exceptional level of communication and thoughtfulness, and a rare level of empathy and caring for the patient. No hospital board protects you by judging the quality of a surgeon's rhinoplasties and prohibiting him from operating if he's terrible. It's the wild, wild west out there, folks.
More plain talk: should you let your primary surgeon perform your revision?
First, you need to consider whether things didn't turn out great on your first operation because of some unusual circumstance with the surgery or the healing, or whether things went wrong because your doctor was not expert in rhinoplasty in the first place.
Evaluate your surgeon again. Read the section above, on how to evaluate a surgeon for a rhinoplasty. If you saw lots of before and after photos of your surgeon's other patients who got excellent results, in noses at least somewhat similar to yours, then your surgeon probably knows what he is doing, and you can consider letting him perform your revision. Even the very best surgeon has the occasional disappointing result.
However, if, on looking back, you decide that you did not do excellent research on your original surgeon -- perhaps you relied on a referral, or on his board certification, without being able to see his photos -- then you probably should not have him perform the revision. If he couldn't get you close to your goal the first time because of a lack of skill, he will have no chance at all on the second try, and then you'll be in the tough position of looking for a third operation.
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