A rhinoplasty or “nose job” can be one of the most transformative facial plastic surgeries. After all, the nose is the center of your face, and not a feature you can downplay or conceal. So when the stakes are this high, explaining your concerns and expectations in detail is crucial to ensure you love your new nose (and you can breathe)!
Houston rhinoplasty surgeon Dr. Taylor DeBusk understands that communicating the vision you have for your nose can be challenging, so in part 1 of this 2-part blog, Dr. DeBusk explains different parts of the nose, common issues for each particular area, and how he addresses them.
Get to know the nose
You don’t need to be a medical expert, but knowing some basic anatomy and rhinoplasty terms can be helpful when describing aspects of your nose you like or dislike.
Nasal tip
The nasal tip, or the “end” of your nose, is framed by two C-shaped cartilages and is a key aspect of your nose’s appearance. We’ll evaluate your nasal tip’s size, shape, and projection (how far the nose tip sticks out from the face) and plan for any adjustments you’d like to make.
Common nasal tip issues we correct:
- Bulbous tip: This is when the nose tip is rounded and notably wider than the bridge. Thicker skin or scar tissue from trauma may contribute to a bulbous tip if you’re not genetically predisposed to this feature. We can create a more proportionate and refined tip during nose surgery.
- Button nose: A button nose typically has a small, upwardly projecting tip, sometimes accompanied by a scooped bridge—also described as a “ski slope nose.” The goal here is usually a straighter, less angled tip.
- Narrow or pointy tip: If the nasal width (the distance between the nostrils) appears thinner than the bridge, it can give your nose a pinched look. Many patients want to broaden this to achieve harmony with the middle bridge.
Knowing basic rhinoplasty terms can be helpful when communicating the changes you want to achieve.
Nasal bridge
The bridge is the nose’s elongated part, starting between the eyebrows and running to the tip. We’ll examine the bridge’s size, width, shape, and projection. We divide the nasal bridge into two categories: the upper bridge and the middle bridge.
The upper bridge is composed of your nasal bones and typically extends from the eyebrow area to partway down the nose, where the cartilage begins. The middle bridge is made of cartilage and extends from the nasal bones to the nose tip.
Here are some common nasal bridge concerns that can be corrected with rhinoplasty:
- Dorsal hump: This is one of the most common reasons people seek nose surgery. A dorsal hump refers to a bump or protrusion on the upper or middle bridge of the nose and can be made of bone, cartilage, or both. Rhinoplasty can smooth out the bridge by removing or reshaping this hump to create a smooth transition from the forehead to the middle bridge.
- Scooped or saddle nose: This is the opposite of a dorsal hump. A scooped bridge looks concave, making it appear scooped out or indented. This effect can be congenital or caused by a previous surgery or trauma. This feature can be corrected by adding a cartilage graft to build up the depressed area for a seamless look.
- Pollybeak deformity: This occurs when there’s an excess of soft tissue or cartilage just above the tip and below the middle bridge (the supratip) that gives the appearance of a “bird’s beak.” We correct this by reshaping or removing the excess tissue during surgery.
- Wide nasal bridge: Some people feel that their nasal bridge is too broad, particularly at eye level. We can narrow the bridge by reshaping the nasal bones.
- High nasal bridge: Some patients have a bridge that starts too high up, close to the forehead. We can lower the radix (the starting point of the nose) for a more balanced appearance and sleeker side profile.
- Low nasal bridge: For some, the bridge might be too low or flat. We can increase the height of the bridge using a cartilage graft.
- Asymmetry: The nasal bridge might be crooked or off-center, often a result of injury, a deviated septum, or natural development. Rhinoplasty can straighten and realign the nasal bridge to achieve a symmetrical appearance and improve your ability to breathe from your nose.
See real patients’ rhinoplasty before and after photos here »
Nostrils
The nostrils are the two external openings of the nasal cavity in the nose. They are usually not a primary concern for all rhinoplasty patients, but the nostrils impact the look of your nose and, potentially, the functionality. Here are some common nostril concerns we can correct with rhinoplasty:
- Wide nostrils: This is the most common nostril feature patients want to address during their rhinoplasty. Nostrils that appear too wide in proportion to the rest of the nose can be narrowed through a procedure called an alar base reduction.
- Asymmetrical nostrils: Sometimes, one nostril can be larger or shaped differently than the other, and we can adjust the shape and size of each nostril to achieve better symmetry during surgery.
- Flared nostrils: Flared nostrils splay outward, like when you are intentionally trying to smell something. We can remove a wedge of tissue at the base to reduce a flared appearance.
- Hanging columella: The columella is the thin strip of skin that separates the nostrils. In some cases, the columella may be overly wide or hang too low and be visible from the side, making the nostrils appear pushed upwards or retracted. We can resize or reposition the columella for a refined nose contour from all angles.
- Nostril retraction or excess nostril show: This refers to nostrils that are pulled upward, and too much of the inner nostril is visible when viewed from the front. We can adjust the angle of the nasal tip and/or use cartilage grafts to lower the nostril rim.
- Thick nostril walls: Some people have thicker skin or more fatty tissue in the nostril wall, making the nostrils appear bulkier. We can remove precise amounts of tissue to refine and sculpt a natural-looking nostril wall.
- Nasal valve collapse: This is a functional issue that occurs when the nostrils collapse inward during inhalation, making breathing difficult. Rhinoplasty can strengthen the nasal valve area to prevent collapse and improve airflow.
- Cleft lip nasal deformity: Patients who have had a cleft lip repair might have residual asymmetry or deformity in the nostril area, and we can help fine-tune the results of previous surgeries for more pleasing cosmetic results.
Now that you know your way around the nose, we hope you feel more confident about discussing the cosmetic and functional changes you’d like to achieve with your rhinoplasty procedure.
In part 2 of this blog, Dr. DeBusk explains how you can make the most of your rhinoplasty consultation and collaborate on a personalized surgery plan to achieve a functional, natural-looking nose contour you are happy with.
Dr. Taylor DeBusk is an ENT-trained facial plastic surgeon specializing in rhinoplasty, revision rhinoplasty, and other complex face and neck procedures. To schedule your consultation with Dr. DeBusk, please call Basu Aesthetics + Plastic Surgery at (713) 799-2278 or contact us online. We offer consultations at both locations, in the Galleria and uptown Houston area and Cypress. Dr. DeBusk performs all procedures on-site in our private, state-of-the-art surgery center.
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