Is it possible to make the nose smaller?
The nose is the central facet of the face, so a nasal structure not in harmony with your other facial features is often a source of insecurity. “A patient will often ask me if I can make the nose smaller or more in keeping with the rest of their face,” explains rhinoplasty expert Mr Annakan Navaratnam. “They are often concerned because they have a large dorsal hump or what they describe as a very protruding nose.”
Rhinoplasty is the only surgical procedure that can make the nose smaller, but as Annakan explains, function must always be considered alongside form and future-proofing the results.
“There are specific surgical techniques you can do to reduce the size of the nose, which we describe as de-projecting or de-humping the nose.
“However, this can be out of harmony with the rest of the face, especially considering ethnicity. I focus on keeping any changes in harmony with your other facial features.
“If a patient wants an appearance that is particular unnatural or not in keeping with the harmony of the rest of their face; then it’s usually not something I am comfortable with. I’ll counsel them and explain that my approach is different and that I may not be the right surgeon for them.
“If a patient wants to reduce the size of their nose I would aim to do this whilst keeping it in harmony with the other facial features and protecting functionality.”
Surgical techniques to make the nose smaller
“If we are straightening a nasal hump, this can be done through a closed approach in some cases, especially if there’s not significant nasal deviation.
“Another technique we can use is preservation rhinoplasty, which preserves the many of the structures of the bridge of the nose but flattens it by making incisions and removing tissue inside the nose. Both preservation and a closed approach for de-humping is possible.
“However, if the patient wants the nose de-projected (reduce in size), this typically requires an external approach, with an incision under the columella. This gives me better control of the structure of the nose to ensure the patient retains an adequate airway.
Planning for the future
“There are techniques you can use where you can quickly de-hump a nose and reduce the size of it. The nose can look good initially, but after a year or so, you risk complications such as inverted V deformity.”
Inverted V deformity is a common complication after rhinoplasty to reduce the size of the nose. It occurs when the cartilage in the upper part of the nose collapses, creating a noticeable depression in an inverted V shape instead of a smooth transition from bone to cartilage. As well as being aesthetically unwelcome, it can cause breathing difficulties.
“I reconstruct the nose to ensure that you can breathe through the nose now and in the future. This is particularly important as you get older, as there can be issues such as inflammatory conditions or swelling in the nose.
“Both privately and in my NHS practice, I see cases where patients have had a rhinoplasty to produce a smaller nose and, five years or so later, they can no longer breathe through it easily. Revision rhinoplasty may require spreader or cartilage grafts to provide structural support and restore both form and function.”
Complications such as inverted V deformities are more challenging to correct than prevent, so choosing the right rhinoplasty surgeon at the outset is essential. Call +44 (0)203 627 2918 or email secretary@annakan.co.uk to arrange a consultation with rhinoplasty surgeon Mr Annakan Navaratnam.
