Are My Rhinoplasty Goals Achievable?

Q: Dr. Eppley, I’m interested in having rhinoplasty and am wondering if my goals for the procedure are achievable. 

1 – My nose looks better when I flare my nostrils vs when they are at rest. When flared, my nostrils are lifted and take on more of a “v” shape than an “m” shape. I would like my nose to look like it does when flared but at rest. Aside from that, i would also like to have my nose made smaller while avoiding the typical things that can be seen in ethnic rhinoplasty, such as: triangular nostrils, a  “pinched” tip, nostrils that are far bigger than the tip etc. In other words, i just want to look natural. I’m fine with just a modest size reduction, I’m more concerned with shape than size.

2 – I’d also like for the columella/bottom of the nose to be made fuller/longer and for the nose itself to be lengthened by a few millimeters. I’ve included one picture to illustrate the “ideal” nose and how the bottom part of it is fuller than mine. There is one more picture that shows a perfection mask based on the golden ratio placed over my nose. This is just to highlight the imperfections. 

Are any of these things achievable through surgery? Would you mind creating a morph that illustrates how close my nose could be made to what I have described here?

Thank you for reading.

A: Thank you for your inquiry and sending your pictures. In terms of your aesthetic goals, some of them are incongruent with others. With your thick nasal skin the goals of making your nostrils more flared and the tip longer does not mesh with an overall goal of making the nose also smaller. You may be able to give it a better shape but not truly accomplish much of a size reduction. With your thick nasal skin there would never be a concern about having a pinched tip or sharp triangular shape to it..

Dr. Barry Eppley
Indianapolis, Indiana