Q: Dr. Eppley, I am in dire need of a nose job. My nose is extremely wide and my profile slopes terribly, which explains my insecurity. I was hoping I could get an estimate for the surgery. I have attached pictures so you can see what needs to be done. Thank you for your time.
A: Thank you for sending your pictures. What you have is a a very specific type of aesthetic nasal deformity in which the lower alar cartilages are very thick and strong. They overproject beyond the tip of the nose making it very broad and fleshy. With that comes broad widely-spaced nostrils. Since the tip is so broad, the area above it (known as the middle vault) looks collapsed and sunken in on profile. This then makes the upper part of the nose where the bones are also appear wide. This can be treated by an open rhinoplasty procedure that narrows the nasal tip cartilages, narrows the width of the nostrils at their base, builds up the middle vault and narrows the upper nose by osteotomies. Together this will help change your nose to one that is less broad and more refined looking. This is a 2 hour rhinoplasty procedure done as an outpatient under general anesthesia. All costs combined place the price of such surgery between $ 6,000 to $ 7,000.
Dr. Barry Eppley
Q: My nose is fatty from the tip area. When I smile it becomes even more broad. Should I get just the tip changed or should I go for whole nose plasty. I have attached some photos for you te see what my nose looks like.
A: When considering rhinoplasty, it is important to first look at the whole nose. While it may be that just the tip area seems to bother you, the problems with the tip may extend up into the upper two-thirds of the nose as well. This would be very common in the broad or wide nose. ln reviewing your pictures, you have a rather classic ethnic nose. (Indian) The nose skin is thick, the tip is broad, the nostrils are slightly flared, there is a hump that extends up into the upper third of the nose and the nasal bridge (bone) area is wide. In essense, your broad nose is not just limited to the tip area. Rather it is an aesthetic issue that extends throughout the entire nose. Doing just a tip rhinoplasty alone may likely leave you unsatisfied with the final result. I would recommend a complete rhinoplasty in which the hump can be removed, the bones narrowed, the tip reshaped to be less broad with increased tip rotation and the nostrils narrowed. I think you will be far more satisfied with this rhinoplasty result. The differences between a tip and full rhinoplasty can be easily illustrated with computer imaging before surgery.
Dr. Barry Eppley