Dr. Sam Lam Plastic Surgery Forum

hi,
thanks for the question. here is how i would approach this: if you have a functional problem (breathing), then a formal revision rhinoplasty is preferred with attention toward breathing. however, in my opinion if the problem is purely cosmetic, i typically recommend a tiny bit of permanent filler to fix it unless the bones are clearly off kilter. the reason for this is that bone realignment to be dead center is not 100% reliable and sometimes i still need a drop or 2 of silicone to make it as straight as possible. plus, the area you are talking about (the scroll) is typically becomes subluxed or the upper lateral cartilage falls inward making just bony realignment not helpful in correcting the situation. hope that helps as a start.
best,
dr. sam lam

ok, then you really need a rhinoplasty that may include the following osteotomies to straighten the bones, septoplasty and possible turbinoplasty (in general i do not believe in removing turbinates just moving them over if need be). as this sounds more functional than cosmetic with some cosmetic insurance will probably cover it. since i don't take insurance, i wouldn't be the most cost effective solution for you. probably would recommend an ENT who can do cosmetic nose work. if you don't have insurance or don't want to go through insurance then i could be a good option to help you.
best,
sml

no problem. i don't see much difference but the angle of your nasal tip which most likely is due to photographic angulation. it will never be perfect but i think i can get you pretty close to where you want it to be. how close? i hate percentages because your 50% maybe my 80%, etc. that being said, i think i can help you with some silicone micro droplets if it is just a cosmetic issue based on the photos. i doubt you need surgery.
best,
sml

if you are just getting a septoplasty, you don't need to fly in to see me. most docs out there who are ENT board certified are capable of doing this procedure well. however, if you are considering any tip plasty or other cosmetic changes to your nose other than just straightening the nose, then i would not do the septoplasty until you see me because i use the septal cartilage to design my nasal tip while at the same time straightening it. if you are interested in a formal rhinoplasty, you can contact my office: marcy@lamfacialplastics.com.
best,
dr. samuel lam