Rhinoplasty is a big subject and it would take a whole book to get into every rhinoplasty technique that might play a part in feminising a nose – basically, it’s pretty much all of them, but I will go over some of the key issues here.
Men typically have larger noses than women, so a feminising rhinoplasty often involves making the nose smaller overall. Sometimes, that’s the only change you need to make if the overall shape is already feminine.
2. Removing a hump:
Having a hump to your nose is not technically a masculinity, but removing it will often have a feminising effect. Think of a humped nose as “gender neutral” – lots of women have them, and so do lots of men. However, the hump is a little stronger in men, so reducing it has a feminising effect and you can keep going until it is gone altogether, or even beyond that to a scooped bridge, but see the questions section below for more on that.
3. Narrowing the nostrils:
This is called “alarplasty” and is quite a common procedure in feminising rhinoplasty because men typically have wider nostrils than woman. A small narrowing can often be done with incisions inside the nose where the scars won’t be visible, but larger reductions can involve external incisions along the edge of the nostril. This will leave visible scars so it needs very careful consideration. In my opinion, in most cases, a subtle narrowing without scars is better than a strong narrowing with scars, but if you are not at all bothered by visible scarring, you may feel differently.
4. Lifting the tip:
If you look at noses from the side, and look at the angle between the base of the nose and the face, you will see that masculine noses tend to come out of the face at more of a right-angle, and feminine nose tend to be angled upwards more. Creating this upwards angle is one of the key procedures in feminising rhinoplasty.
5. Thick skin:
This is an important issue in rhinoplasty, and skin thickness varies a lot from person to person, and from ethnicity to ethnicity. If your skin is very thick, then it can hide a lot of the changes you make to the underlying structure during rhinoplasty, and this obviously puts a limit on the amount of change you can make. In fact, in a patient with very thick skin, even a very drastic reduction of the underlying cartilage, might make hardly any difference to the outward appearance.
There are ways to thin the skin, but this is something you need to consider very carefully because it can increase the risk of complications. It’s also quite limited in the degree of thinning you can achieve.
6. Visible columellas:
The columella is the bit between your nostrils and on some people it is very visible from the side. This is not a gender issue, it’s purely a beauty issue (and therefore completely subjective) but I am including it here because it is quite often dealt with at the same time as feminising rhinoplasty.
Basically, there are 3 reasons why your columella is more exposed than average – the first is that it hangs lower than normal, the second is that it doesn’t hang low, but that the nostrils are higher than average, and the third is when you have a low columella and high nostrils at the same time. The columella can be lifted if necessary, and nostrils can be lowered with an “alar rim graft” so all 3 situations are fixable in most cases.
This is also not really feminisation, but again, people who have noses that aren’t straight, will often ask the surgeon to straighten them during a feminising rhinoplasty. This can involve all sorts of techniques, but the key thing to understand is that it’s not always possible to completely straighten a nose. You can certainly expect an improvement, but don’t expect perfect symmetry. Also remember that some nose asymmetry is normal (no one has a perfectly symmetrical face).
8. Breathing problems:
Again, not feminisation, but if you do have a problem with the airflow through your nose, it may be possible for the surgeon to correct this during rhinoplasty depending on the nature of the problem and the particular techniques the surgeon can perform, so don’t hesitate to talk to them about it.