Dr. Sam Lam Plastic Surgery Forum

My nose is slightly red and look swollen most of the time.
My skin surface has a few visible vessels but my skin still looking normal not that rough surface looking.
My nose tip is big and looks fat. I don't know if rosacea has caused me a big nose or my nose tip tissue grows during puberty.(the redness and size growth happened at the same time.) But when i am small I can still know that my nose tip and nostrils are not that good looking. My nostrils look like small equilibrium triangles.
My nose bridge is flat too but I don't care and I just want my nose tip to look normal.
I need a surgery to make my nose tip smaller but I am afraid if it will make my rosacea worse. I am not sure which is the cause of the big nose tip and i just want to make my nose smaller. I just turned to my twenties. I have been upset with it for long time.
Also, I am afraid that if the removal of the tissue from my nose will cause deforms in the future.

hi,
i would obviously recommend you see a dermatologist first since we would then be able to discern what component is rosacea and treatable with a combination of topical products and lasers. once we have established how much is rosacea and how much is your normal nose, we can proceed with rhinoplasty.

remember that ideal results with rhinoplasty in your head may not ever be achievable given your natural nose tissues. a lot of us want to be 6'1" but some of us can't be. that is life.

if you have a bigger nose tip and a flat bridge, the first order of business is to raise the bridge even if you don't want to. the reason is that an Asian with a very thick skin and nose tip shape can almost never have a tiny tip so raising the relative size of the bridge is an easy way to create more balance between the bridge and the tip. just like a small chin can make a tip bigger, a chin implant can create the illusion that the nose tip is smaller in the right individual who needs one. also understand that i don't make nose bridges too high: i maintain ethnicity as i think very high bridges on Asians look ridiculous.

As far as the tip goes, i would have to undergo a consultation with you in person to make that judgment. I have a lot of techniques to make a nose tip smaller and it all depends on what I see and feel with your nose. obviously, we can do a phone consult if you live out of town, but there is no substitute for an in-person consultation. remember now, we have to look at the balance between the very central tip of the nose and the sides of the nostrils. at times, we want the nostrils smaller but if they look like slits as you are suggesting or the central tip is particularly big, reducing the sides will only make the central tip look too big.

best,
sml