Your Questions
Your Questions
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
Indianapolis, Indiana
Q: Dr. Eppley, I have a rather big nose (and it become much more bigger when I smile or grimace). How much of it can be reduced by rhinoplasty? Can I have nose like, for example, Angelina Jolie? And the other question is will my nose get bigger the (when I smile or grimace) after nose job?
A: The first concept to grasp about rhinoplasty surgery is that you can not have a nose like someone else. While it is important to have a surgical goal, looking like someone else’s nose is not realistic. This is particularly true when it comes to a large nose with thick skin. There are simply limits as to what can be achieved based on the amount and thickness of the nasal skin cover. Whether rhinoplasty is worthwhile for you, or any patient, requires some sense of what the result may be using computer imaging. When done carefully by an experienced rhinoplasty surgeon themselves, you will get a much better sense of whether rhinoplasty can make enough of a difference to justify the effort. When I do rhinoplasty computer imaging, I always show the most conservative or least achieveable result that I think can happen. That way if the patient chooses to have rhinoplasty surgery, they will not be disappointed and make even be pleasantly surprised if even more of a result develops.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I am interested in having a rhinoplasty for my big nose but don’t want it to make my already large brow bones to look even bigger. I have attached a couple photos (front and side) of myself to give you a better idea and possibly even hear any other suggestions you may have to maybe give my face a better balance. I did have a rhinoplasty when I was younger but it didn’t make much of a difference. I was going to have a second rhinoplasty, but I didn’t want a smaller, well-proportioned nose to create my brow bone to appear larger than it already is. In other words I thought my nose being somewhat larger now balances out my brow bone.
A: Thank you for sending your pictures. I have done some computer imaging to demonstrate several points. Your first rhinoplasty result is not very impressive and probably shows little change. I suspect it was done as a closed rhinoplasty by someone with little experience in doing the procedure. But doing your secondary rhinoplasty would actually make little difference in how prominent the brow appears as demonstrated in the attached imaging. Making your nose bette balanced does not make the brow bone prominence look worse and that is well demonstrated in the computer imaging. The reverse is, however, quite different. Reducing the prominent brow bones would definitely make the nose look even bigger. I have demonstrated the combination of a rhinoplasty and brow bone reduction to see the total change. Therefore, you could feel quite comfortable doing a secondary or revisional rhinoplasty without fear of making any part of the rest of your face look more out of balance.
Dr. Barry Eppley
Indianapolis, Indiana