Q: Dr. Eppley, I want to have a rhinoplasty to change the shape of my nose. I am Hispanic and I don’t like my thick wide nose. I will try to the best of my ability to describe what my goals are. I would like my nose to be more narrower from the top to the bottom. I would also like the side of my nose to be smaller and also a smaller yet defined tip. Its hard for me to explain but in person I can explain better but over all this is the work I would like done on my nose. I have attached pictures from the front and side for you to see what my nose looks like.
A: Thank you for sending your pictures. In looking at your nose and your reshaping goals, I think much of that is achieveable. To achieve an overall nose thinning, I would use an open approach with the following steps; radix cartilage augmentation (build up the nasal root), low lateral osteotomies (upper nasal bone narrowing), tip refining through lower lateral cartilage trimming, suture plication and a columellar strut graft, and alar wedge reduction. (nostril narrowing. It is important to realize that the amount of overall nasal slimming that can be achieved is controlled by the thickness of one’s nasal skin and how much it will contract. Given your ethnicity and thicker nasal skin, there are limits as to how much thinning can occur. I have attached some computer imaging to show what I think is a realistic outcome. Most of the benefits of this proposed rhinoplasty procedure will be seen in the front view and not so much in the side view since no dorsal profile change is being done (with the exception of radix augmentation and the tip is not undergoing any projection changes.
Dr. Barry Eppley