When we look in the mirror or look at our selfie that we’ve just taken on our smartphone, one of the first features we notice about our appearance is our nose. We notice right away if it doesn’t look right – it’s too big, has a hump, or it’s pointing anywhere but straight down where we want it to. Many patients who come in to see me, are looking to reduce the size of their nose. This is one of the most common concerns and it can start as young as boys and girls in their early teens all the way to patients in their 70s and 80s. The one thing that most patients never consider is the size of their chin and how this affects their profile features and the overall appearance of their face. You see, our faces have to be proportional and the chin and nose work hand in hand to give that harmonious look between the facial proportions. I have seen many patients who think their nose is too big, but yet they don’t realize that the reason might be is that their chin is too small (microgenia). This can enhance the look and feel of the nose so as to seem disproportional to their face, but the chin is the culprit. That is why I always look at the entire proportion of one’s face and profile when I see patients face to face. I need to look at their profile and assess how the chin impacts their look. In these situations, we like to take a real life picture of the patient and “image” their profile to show them what they could look like if we not only reduce the size of their nose but also augment the chin to achieve a greater result. Sometimes all a patient may need is a chin augmentation in which case I will recommend only doing that procedure. At a later time, some months down the road, the patient will have a better appreciation of their proportional features and we can always address the nose at that point if needed.
Other times, patients want to shorten their nose and reduce the overall size but the patient fails to consider and appreciate how strong their chin is on a profile view. Of course when we take selfies, all we see is that big noggin, but no one ever takes a profile selfie to see how it looks from the side in relation to the chin. If I were to reduce the nose considerably, then the chin would appear out of proportion to the rest of the face and ultimately draw attention to its size. This is especially important for female patients as men prefer and require a strong profile enhanced by a strong chin, but women want and require the opposite. In this situation, I will sit down with the patient and image their nose illustrating the desired goal relative to the chin. The goal is always to achieve the result the patient is desiring so long as the patient is taking into account the chin and nose working in unison for giving us the desired look.
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