I'm Unhappy with my Nose - What are my Options?

If you don’t like the way your nose looks, you’ve probably spent a long time wondering if you should do something about it - and, if so, what?

It can be difficult for people to tell what actually needs to be done to their nose to improve its appearance. In this article, we’ll help you understand the most common reasons people are unhappy with their noses - and the best treatments to correct them, including non-surgical options.

If your nose is too big

An ideally proportioned nose is one that’s in harmony with the rest of the facial features. If a nose projects too far out, it will look off-kilter and be very noticeable. To assess if the nose is too big, vertical and horizontal measurements are taken. The horizontal measurement is then divided by the vertical measurement. The optimum range is 0.55 to 0.60. 

To reduce the projection of the nose, a reduction rhinoplasty is needed. The procedure involves removing some cartilage and filing down the bone to bring measurements into the optimum range. 

If your nose is too small

If your nose falls below the ideal 0.55 to 0.60 size range it can also look out of proportion (according to Caucasian facial proportions). The projection of the nose can be increased non-surgically by injecting dermal filler (with the result lasting 12-18 months) or surgically, with a dorsal augmentation. 

A dorsal augmentation uses either a silicone implant or -preferably - your own septal cartilage to build up your bridge. If you don’t have sufficient cartilage, a rib or bone graft can also be used.

If your nose is too long

To analyse if the nose is too long for a face, surgeons divide the face into three equal sections horizontally. If the nose extends lower than the middle third of the face then it is too long. This is usually caused by an overly large nasal tip and/or hanging columella (the bit between the nostrils).

The angle of the tip of the nose (the amount the nose is turned up) also plays an important role. Measured from the lip up, the ideal range of rotation is 90 to 100 degrees for men and 95 to 110 degrees for women. A female nose that is rotated less than 90 degrees to the face looks droopy, long and masculine.

If the over-projection of the nasal tip is modest, the appearance can be improved by placing a small amount of injectable muscle relaxant at the base of the nose in between the nostrils, or possibly into the nose tip itself. This relaxes the fibres of the depressor muscle that pulls the nose downward and lifts the nose for 4 to 6 months. 

Where a greater uplift is needed, or the nasal tip/columella needs to be reduced in size, excess tissue can be removed during surgery and sutures can be placed to alter the angle of the nose.

If your nose is too short

A short nose is one that is too turned up or what is called ‘over-rotated’. It can result in very visible nostrils giving the appearance of a ‘pig nose.’ A mildly over-rotated nose can be improved with dermal filler injections into the bridge. These can soften the appearance and create the illusion of a more proportionate nose.

But for more severe over-rotation, a specialised plastic surgery technique called derotation or counter-rotation is needed. A derotation rhinoplasty procedure requires a cartilage graft (sourced from the septum or rib) to lengthen the nose and correct the position and rotation of the nasal tip. 

If your nose is too wide

The ideal width of a nose differs according to ethnicity. For Caucasians, the optimal measurement is considered to be one-fifth of the total width of the face. A wide nose will usually be caused by a flat and broad nasal bridge but it can also be contributed to by a bulbous or thick nose tip and flared nostrils.

The width of the nose cannot be shrunk without surgery but dermal fillers can add volume and give an illusion of a smaller nose bridge by adding more height. To treat a wide nose surgically, a medial or lateral osteotomy is performed. A medial osteotomy is the reshaping of the midsection of your nose, while a lateral osteotomy involves chiselling the outer, longer sections of your nose bone.

In some cases, both techniques may be combined to produce an overall narrower appearance of the nasal bridge. Surgery to reduce the size of the nasal tip and width of the nostrils (alarplasty) might also be included. 

If your nose is too narrow

A narrow nose can be due to a narrow bridge or a narrow tip. A narrow bridge is often caused by a dorsal hump and can be easily corrected by filing down the bone to give a flatter appearance. However, sometimes it’s due to collapsed nasal bones or cartilages and, in these cases, spreader grafts are needed to widen the area.

Meanwhile, a narrow or pinched tip can be corrected by using grafts to rebuild the proper cartilage support of the nose and nostrils. Where cartilages in the tip are overlapping, soft tissue spacer grafts can be placed to separate them.

There are non-surgical possibilities, though. For some patients, the use of dermal fillers can enhance volume in different parts of the nose. 

If your nose is bumpy or wonky 

A bumpy or wonky nose is caused by a dorsal hump and/or a deviated septum. These can occur naturally or through trauma - a broken nose can result in a dorsal hump if the cartilage and bone heal unevenly.

A dorsal hump can be treated non-surgically using filler above and below the bump to smooth out the transition and make the bump less noticeable. The drawback is that because you are adding volume to the nose it can make it appear bigger. Also, the injections have to be repeated every 12-18 months.

If the bump is small, it can be filed or shaved down, which avoids having to break the bones of the nose but for larger dorsal humps, osteotomy is necessary. This involves making small cuts to the nasal bones where they meet the cheek so they can be repositioned. 

Septoplasty is the usual way to repair a deviated septum. During septoplasty, your nasal septum is straightened and repositioned in the centre of your nose. This may require your surgeon to cut and remove parts of your septum before reinserting them in the proper position. 

Getting the right treatment for your nose

The truth is, getting a perfectly sized and shaped nose for your face may require a combination of revisions. The best way to find out is to have a consultation with a surgeon who can examine your nose and assess it in relation to your other facial features. 

Even if you have a clear idea of what you’d like to achieve, a surgeon will be able to advise what’s actually possible, taking into consideration your anatomy, skin type and overall health. At Ocean Clinic, we can advise on both surgical and non-surgical options for changing your nose. 

Contact us to make an appointment 

What is Composite Breast Augmentation?

Have you heard the term ‘composite breast augmentation’ and wondered what it is? It sounds pretty strange and technical, but actually, composite breast enlargement is designed to give a very natural-looking enhancement to the chest. 

As the fashion for overly-large and artificial-looking breasts moves towards a more subtle aesthetic, composite breast augmentation is becoming increasingly popular.

Ocean Clinic has been a leading force in developing the procedure and, thanks to the enhanced results it offers, it’s being adopted as a protocol of choice by plastic surgeons globally.

Read on to discover how the procedure differs from standard breast enlargement, how’s it’s performed and what the benefits are...

What is composite breast augmentation?

Composite breast augmentation is a procedure that combines traditional breast implants with transplanted body fat. It’s carried out to increase the size of the breasts and/or to enhance their shape.

As well as providing a more natural result, the procedure is popular because it also includes liposuction of common problem areas, like the tummy. Stubborn pockets of fat can be targeted, with the fat then grafted into the breasts. In this way, composite breast augmentation is a 2-in-1 procedure. 

How is composite breast augmentation performed? 

To carry out composite breast augmentation, it’s first necessary to locate donor fat elsewhere on the body. Because of this, the procedure is not suitable for very lean patients, however, most of us have sufficient fat stored in one place or another. 

Fat is most commonly harvested from the stomach, waist, thighs and flanks. It’s extracted with a liposuction cannula, which is small in diameter and requires only very tiny incisions. This means it leaves next to no scarring.

The fat extraction is carried out at the same time as the rest of the surgery, so patients are fully anesthetised. While the fat is being prepared for reintroduction to the body using a centrifuge, the surgeon will make the incisions for the implants. 

These are made in the creases beneath the breasts and are small in size (only about three centimetres). In most cases, the fullness in the base of the breasts will completely conceal the scars when you are sitting or standing.

The implant will then be placed. Composite breast augmentation allows for the use of smaller implants because volume can be added with fat. It also allows for asymmetry to be corrected, since different volumes of fat can be placed around the implants in each breast.

The implants will be placed subpectorally (under the muscle), which helps to produce the most natural-looking results. This is because it creates more cushion between the implant and the skin, so you’re less likely to feel the edges or see rippling. 

The transplanted fat is used to further disguise the outline of the implants. By carefully injecting it into the medial borders, it makes the transition from chest to implant smoother. Fat grafting also gives the surgeon the opportunity to give the patient a nicer cleavage. Providing cushioning between the implants creates a soft undulation, which cannot be achieved with implants alone.

How does recovery from composite breast augmentation differ from regular breast augmentation?

With composite breast augmentation, two separate procedures are performed, so recovery is slightly more extensive. There will typically be some swelling and some bruising where fat has been removed and you will need to wear a compression garment/belt around the donor site for 2-3 weeks. 

The chest will also be more swollen than when implants alone are used. This is because an overabundance of fat is grafted during the procedure to account for the cells that don’t become vascularised (gain a blood supply) and therefore die off. Usually, this is between 40-60%.

It means your breasts will initially appear bigger than they’re going to be once healing is complete. The fat that remains 6 months post-surgery should be with you for the rest of your life. Meanwhile, the donor areas will be more resistant to weight gain due to the removal of fat cells.

Am I a good candidate for composite breast augmentation?

You’re a good candidate for composite breast augmentation if you have small breasts that are in a good position on your chest. Ideally, you’ll have an area/s on your body with an amount of excess fat to serve as donor site/s. If you are on the slimmer side, it’s still possible to remove smaller amounts of fat to be grafted but the benefits will be more modest. 

If you have sagging breasts, you will not be suitable for this procedure as an uplift will be required (take our breast test to check). However, if you have simply lost volume in the upper part of your breasts and the nipple is still in a perky position, composite breast augmentation can yield a great result by replacing lost volume. It’s also a good technique for correcting differences in breast size or shape. 

Would you like to learn more about composite breast augmentation? Contact us for an in-person or online consultation.