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I have a relatively minor problem with my nose that I would like changed but don’t know if it is severe enough to warrant surgery. I don’t want to sound vain but would like my nose changed if you can do something for a minor bump on the top and a slightly full tip. How do you decide when a problem is worth fixing?

Judy C. - Seal Beach, CA

Before we begin this discussion, let us apologize to those of you who had difficulty viewing the photos on our last rhinoplasty e-newsletter. We used very high resolution photos, which apparently, not everyone could open. If you had that issue, please see all of the photos on our website blog pages:

Now back to the above question. Only you can decide if a problem is worth fixing – we are discussing an elective procedure and in order to make it “worth fixing”, it has to bother you enough to have it fixed! Procedures such as rhinoplasties, face lifts, liposuctions, and breast augmentations do not leave much in the way of visible scarring and our threshold for doing surgery is lower than it would be for procedures that leave visible scars. A breast reduction and tummy tuck, for example, leave visible scars and, while they are excellent procedures for patients who are bothered by massive breasts or a very lax abdomen, the same operation and degree of scarring would result if we removed just a little from a breast or abdomen, thus raising our threshold for offering this option to patients. Nasal surgery can be done with a combination of external and internal scars or by using only internal incisions. We prefer the internal incision method in most cases. In this way, we can offer a patient correction of a nasal deformity without worrying about tell-tale signs of surgery, and we are willing to help patients with minor deformities. You mentioned that your friends all think that you look fine – no doubt, to them you do! They do not have to live with your nose and cannot be relied upon to help you make a decision. Do not be surprised if you do your nose and none of those same friends who told you not to do it do not even notice that you did it! Your best bet would be to discuss your concerns with a board certified plastic surgeon.

We will show you an example of a 26 year old singer who, to most people looked quite good before surgery, but did not like the bulkiness of her nasal tip and wished to bring her small bump down. These results certainly are not very dramatic but left the patient with a result that pleased her a great deal. One of the best ways to envision how you would look following such procedures is through the use of computer imaging. If you would like to set up a complimentary computer imagine session, please feel free to contact Orange County Plastic Surgery at 949-997-0796 or Salisbury Plastic Surgery at 508-466-5930.

If you have any specific questions about cosmetic procedures, your best bet would be to see a qualified plastic surgeon to review your options.

If you would like to contact Dr. Ekstrom or Dr. Bunkis,

For CA, please call 949-888-9700 or visit our websites at:

Or for MA location, call 508-755-4825 or visit

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Thanks for staying in touch and for your feedback!