Dr. Thomas Buonassisi, MD, FRCSCDr. Thomas Buonassisi, MD, FRCSC — Otolaryngology – Head & Neck Surgeon with a practice limited to facial plastic surgery, 8 West Clinic, Vancouver, BC.
Published August 7, 2026·Medically reviewed by Dr. Buonassisi
KEY TAKEAWAYS — IN THIS VIDEO
Dorsal humps are a common nasal feature patients seek to modify for a smoother profile.
Tip droop, or tiptosis, can make the nose appear longer and affect facial expressions.
Natural aesthetics are prioritized in modern rhinoplasty to ensure harmonious results.
Dr. Buonassisi · Common Nasal Features Patients Want Modified
Dr. Thomas Buonassisi, MD, FRCSCAuthor · Reviewer
Dr. Thomas Buonassisi, MD, FRCSC — Otolaryngology – Head & Neck Surgeon with a practice limited to facial plastic surgery, 8 West Clinic, Vancouver, BC.
Dr. Buonassisi is certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) and the American Board of Otolaryngology – Head and Neck Surgery (ABOHNS), and is a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCSC) and the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). He co-founded 8 West Clinic — a rhinoplasty-focused practice in Vancouver, BC — with his wife Angie Buonassisi, with two locations in Vancouver and North Vancouver, with patient education as a founding principle of the practice.
Dr. Buonassisi has been educating patients on rhinoplasty for over 15 years and has published hundreds of educational videos across YouTube and Instagram — with content going back over a decade. Every article and video in the Knowledge Hub is written or reviewed directly by Dr. Buonassisi.
What Nasal Features Do Patients Commonly Want to Modify?
Many patients seeking rhinoplasty have specific nasal features they wish to modify. One of the most common concerns is the presence of a dorsal hump. This refers to a noticeable fullness or extra height along the bridge of the nose, which can affect the overall profile and aesthetic balance of the face.
Another frequent issue is tip droop, medically known as tiptosis. This condition can make the nasal tip appear longer and may be more pronounced when smiling or talking. Patients often express that a droopy tip makes them look less approachable, highlighting the importance of both aesthetic and social factors in rhinoplasty considerations.
Understanding the Dorsal Hump
The dorsal hump is a structural feature that many patients wish to address through rhinoplasty. It can be composed of bone, cartilage, or a combination of both, contributing to a prominent nasal profile. Reducing a dorsal hump can create a smoother, more harmonious nasal contour, which is often a key goal for patients seeking a more balanced facial appearance.
Dr. Thomas Buonassisi, MD, FRCSC, with over 25 years of experience in facial plastic surgery, emphasizes the importance of maintaining natural aesthetics when addressing dorsal humps. The aim is not to create a perfectly straight nose but to refine the shape in a way that complements the patient's facial features.
Addressing Tip Droop or Tiptosis
Tip droop, or tiptosis, is another common concern among rhinoplasty patients. This condition can cause the nose to appear longer and affect facial expressions. It is particularly noticeable in some individuals when they smile or speak, leading to a desire for correction.
Dr. Buonassisi approaches tiptosis with a focus on achieving a natural-looking result. The goal is to subtly lift and refine the nasal tip, enhancing the overall facial harmony without creating an unnatural or overly pointed appearance.
The Importance of Natural Aesthetics in Rhinoplasty
In the past, trends in rhinoplasty often leaned towards creating overly refined or pointed nasal tips. However, contemporary practices, as advocated by Dr. Buonassisi, prioritize natural aesthetics. The aim is to enhance the nose's appearance while ensuring it remains in harmony with the patient's other facial features.
Dr. Buonassisi's approach involves careful consideration of each patient's unique anatomy and aesthetic goals. By focusing on subtle refinements rather than drastic changes, he ensures that the results look natural and complement the patient's overall appearance.
Full Transcript
What are the typical nasal features that people want to modify with surgery? Most common by far is a dorsal hump, and that just means that there's a little bit of fullness or extra height on the bridge of the nose. The other very common concern that patients have is that the tip droops. We call that tiptosis. Sometimes it's worse when people smile or talk. Other times it's just sort of droopy at rest and it tends to make the nose look a little bit longer. Sometimes people feel as though they don't look as approachable when their tips are hanging down a little bit, which I find kind of interesting. I think the days where people are making the tips super pointy hopefully are gone because that doesn't really look very natural. We don't necessarily wanna make someone straight and narrow, but a little bit of refinement can help the shape of the nose look more attractive.
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