Your complaint is a common one in patients seeking revision rhinoplasty. But even if you have never had a rhinoplasty before, some patients are born with upturned noses.
The solution is known as derotation of the tip. Adding length to the top of the nose is usually the only means by which the tip cartilages can be rotated down. Multiple techniques such as dorsal onlay grafting (with rib cartilage), extended spreader grafts, and suture techniques are often combined with extensive skin release and undermining to set the tip down and keep it there. The surgeon has to combat internal forces in the nose and changes that internal scarring can create to keep the position of the tip stable. This is typically a difficult maneuver. Make sure your surgeon is comfortable with revision rhinoplasty techniques.
