I am interested to know if you have had a rhinoplasty in the past? If the overrotation you are experiencing has occurred from a previous rhinoplasty then I would recommend caution and engage the services of someone comfortable with revisional work. Certainly more photos would provide a clearer picture. But regardless...
Reduction rhinoplasty (removal of more cartilage) from the nasal tip is unlikely to provide derotation. Trimming of cartilage from the anterior septal angle would provide a delicate derotation and in combination with suture fixation of the nasal tip complex to the newly positioned septum would provide the desired result (a reverse tongue in groove technique).
The analogy I would provide is entering a tent and shortening the long supporting tent pole to lower the tent closer to the ground leaving the generic shape the same. That is not an exact analogy depicting the intricacies of the operation, of course.
Always feel comfortable having a second consultation with your surgeon to ensure that the goals and operative plan match your expectations.
Regards,
Dr. Pryor
