BEFORE & AFTER
Male large, bulbous nose — before and after at 2 months: male rhinoplasty that refined the nose by reducing rather than raising it
Male rhinoplasty · Large nose · Bulbous nose · Alar reduction · Osteotomy · Custom silicone · 2 months
Outcomes and side effects vary from person to person. Bleeding, infection, swelling and asymmetry may occur. Please consult our medical team before making a decision.
These KOWON Plastic Surgery male rhinoplasty before-and-after photos were taken 2 months after surgery. Unlike the photos taken right after surgery, much of the swelling has gone down and the osteotomy and alar incision sites have largely settled, so this case shows how the result of large-nose surgery in a man actually settles in.
Hello, this is Dr. Kim Hyung-taek of KOWON Plastic Surgery.
These are side-view photos, taken 2 months later, of the male patient introduced earlier with photos taken right after surgery. In male rhinoplasty, “not obvious” is the first condition for almost everyone, so whether it still doesn’t look operated-on after the swelling has gone down becomes the measure of the result. This patient wanted to reduce a large, heavy-looking bulbous nose, and was worried about the tip spreading when he smiled and about the philtrum looking unnatural.
What changed in the 2-month side view
Before surgery, the dorsum stood out wide and thick, and the tip, with thick skin, drooped and was bunched into a round shape. The columella under the tip also drooped, so the nostrils looked stretched from the side.
In the 2-month photo, the dorsum runs smoothly in one line from the glabella to the tip, and the drooping tip has been brought forward, so the whole nose looks a step smaller. The bridge height itself is almost unchanged. That is because the wide nasal bones were brought inward with an osteotomy to narrow the dorsum, and a custom silicone implant, carved thin to fit this patient’s nose, was placed on top only to refine the line. In a man’s nose, I use silicone less as a material for adding height than as a way to continue the narrowed dorsum up to the glabella with a natural, masculine feel. This is why no implant outline shows on the bridge in the 2-month photo.
How much is a bulbous nose reduced at 2 months?
In bulbous-nose surgery, the tip is the area where swelling goes down last. Especially in a thick-skinned male bulbous nose like this patient’s, by 2 months the swelling of the bridge has almost gone, but a little remains at the tip. So it is normal for the tip in this photo to look slightly larger than the final result, and it should become gradually more defined over the next few months.
As I explained at consultation, there is a limit to how much a large, bulbous nose can be reduced. The soft tissue of the tip can be removed and the splayed cartilages brought together, but skin thickness is something each person is born with, so a fully thin tip cannot be created. In my long experience, pushing too far here can leave the tip bumpy or damage the skin, so for this patient the tip was refined within a safe range, and the bridge and alae were reduced as well so that the nose as a whole looks smaller. The 2-month photo suggests that this approach suited him.
The alar incision scar and the tip when smiling
Because an incisional alar reduction was done, there is an incision site at the base of the alae. At 2 months some redness remains, but because the incision follows the crease where the ala meets the face, it gradually becomes less noticeable over six months to a year. Men often worry a great deal about scars, but this area is naturally shadowed, so it is uncommon for the scar to stand out from the front or the side.
The tip spreading when smiling was addressed by bringing the tip cartilages together and supporting the tip with septal cartilage. By 2 months, patients usually notice for themselves that the tip spreads less when they smile; and because a hanging-columella correction was done as well, the stretched look of the nostrils from the side has been tidied. The philtrum was left at a natural angle, as he wanted, without being forcibly lifted.
[OP PLAN]
- Diagnosis: large nose + bulbous nose, wide bridge, drooping tip, flared alae (male)
- Patient’s requests: improve the large, bulbous nose, reduce tip spreading when smiling, keep the philtrum natural, keep it from looking obvious
- Tip: tip soft-tissue removal + bringing the tip cartilages together + tip support with septal cartilage
- Columella: hanging-columella correction
- Bridge: osteotomy (narrowing the dorsum) + custom silicone – height kept, for refining the line
- Alae: incisional alar reduction
- Approach: open rhinoplasty (open incision)
- Photos taken: 2 months after surgery (side)
See this patient’s photos taken immediately after surgery
Two months after surgery, most of the swelling of the bridge has gone while some remains at the tip; the changes in line and size can be seen, but the tip still has room to become a little smaller.
KOWON Plastic Surgery starts from natural-looking change, but aims beyond a result that simply doesn’t show — for a “natural-glam” rhinoplasty that brings out the flow of the line and its details.
As the remaining swelling of the tip subsides and the alar incision fades, the nose settles into a neater shape than it has now. When osteotomy and alar reduction are done together, it takes a little longer than other rhinoplasty to reach the final result. Rhinoplasty results can differ with each person’s skin thickness and cartilage, and the settled final result can be seen after a sufficient recovery period.