How Do I Achieve A Rhinoplasty That Does Not Look Too ‘Surgical’?

Q: Dr. Eppley, I am interested in rhinoplasty surgery. I guess my wish list is quite long, but I don’t want to look like a different person. I’d like to reduce or remove the hump and slightly shorten its length. Also, on front view it seems slightly crooked and very wide, especially when I smile. If you could magically decrease my excessive snoring, my husband would probably appreciate that too! I’ve spent a lot of time thinking about this and looking at pictures online. I think a lot of doctors go too far for my personal taste. One common thing I see online is when humps are removed and the nose ends up actually dipping down in the middle where the hump once was. I don’t care for that. I also think some take off too much length and drastically change the side profile. I am looking for something more subtle.

A:Thank you for sending your pictures in consideration of rhinoplasty surgery. The type of nose changes you are after is a straight nasal dorsum and decreased nasal tip length with minimal tip rotation upward. Trying to not make your nostrils flare when you smile is precarious as decreasing the action of those muscles to do that can also affect the way your upper lip moves when you smile…which would not be a good tradeoff. The best you can do in that regard is to minimize the amount that the nasal tip pulls down when you smile. As for breathing improvement that would depend on what the inside of your nose looks like and whether you have any significant airway impingement by septal deviation and/or inferior turbinate hypertrophy.

The best way to avoid having radical nose changes from rhinoplasty is to not over resect or remove too much cartilage or bone tissue. Knowing your nasal change desires as being a subtle change helps your surgeon know how aggressive or conservative to be when performing rhinoplasty surgery.

Dr. Barry Eppley

Indianapolis, Indiana