Q: Dr. Eppley, I want a reductionrhinoplasty that will really make my nose smaller. I have attached a picture which shows how much reduction I want. Is this possible?
A: The limitations of a reduction rhinoplasty are largely skin thickness based. In thick skin more major support reduction (osteocartilaginous structures) can be met with ‘skin resistance’. This is most manifest in the nasal tip area where thick skin has a propensity to ball up rather the than shrink down. This results in not the desired tip refinement but a persistent wide ill defined tip despite what has been done to the tip cartilages underneath. The amount of nasal reduction you are illustrating overall I do not think is a realistic one and certainly not an advised one. Your nasal skin is thick not thin and your tip area will likely suffer the very complication of which I just described. While I do computer imaging with the most conservative change possible, so as not to over promise any result and it is likely more reduction/refinement may occur that what is shown, I know that what you are desiring can not be achieved. At best in my hands the result may be halfway between what I have imaged and the amount of overall nose reduction you are desiring.
Dr. Barry Eppley