In our weekly Post Your Face column, Dr. Robert Freund answers readers' cosmetic surgery questions, and shows them how they'd look if they underwent the enhancement. To post your own face, visit postyourface.com.

The Patient's Question: I have always had a dominant nose and it seems to have only gotten wider since I had children. I want a petite nose that compliments my facial features instead of drawing away from them. I have also played with the idea of plumping my lips a bit, but maybe once my nose is slimmer, my lips will end up looking more full naturally. Please help me out!



Dr. Freund's Answer: Let's take your concerns one-by-one:

Nose: I think your nose is of a nice natural length, but I agree with you that the middle part is a bit wide and with just a bit of narrowing you will certainly see – and hopefully feel – a big change. The techniques necessary to create this change are part of a rhinoplasty procedure (Nose job). The typical rhinoplasty costs from $4000 to $8000 depending on the doctor's skills, region of the country and the amount of surgery performed. I would expect your procedure to be at the lower end of that number.

Lips: In regards to your question about whether a nose job might help your lips look larger - the answer is partially yes. As your nose decreases in size, other features of your face will become larger, relative to your nose. For instance, by narrowing your nose, the beauty of your full cheeks and oval shaped face will be enhanced. Your lips will also look wider, but slimming your nose will not change how full they look. This can be done easily with quick filler.

Your lower lip is fine, but you have very little upper lip. Ideally the upper lip should be 40% of the vertical height of the lips and the lower lip should be 60%. In your case, the ratio of your lower to upper lip is more like 80:20. The two ways to correct this discrepancy are to reduce the size of the lower lip (not in your case!) or increase the size of the upper lip.

There are several different types of fillers available for lip enhancement:

Collagen

• - cheap ($400/ml)
• - short-lasting (1-3 months)
• - may require a skin test to avoid an allergic reaction

Hyaluronic Acid (Restylane/Juvederm)

• - more expensive ($600/ml)
• - longer lasting (2-5 months)
• - no allergy testing necessary

Fat (Viafill)

• - more expensive, but much more volume available
• - longest lasting, may be permanent
• - safe, it is your own tissue, no allergy test required

Silicone

• - same price as Hyaluronic Acid ($600/ml)
• - permanent!
• - can cause lumpiness, inflammation and localized scarring. Because it is permanent and has these risks "buyer beware!"

Everything I have discussed here, as well as anything else you need to know about skincare, facial fillers and other plastic surgery procedures, is concisely discussed in my book "A More Beautiful You : Reverse Aging Through Skin Care, Plastic Surgery and Lifestyle Solutions."

I hope this helped you see what you could expect from surgery and fillers. Good Luck!

Respectfully submitted,

Robert Freund, MD, FACS

The health or medical information in this article is for informational purposes only and is not intended to be used as a substitute for professional medical advice, diagnosis or treatment. Please consult your doctor or a qualified healthcare provider with any questions.