I spoke to a doctor who said that the only way to make a nose shorter is to rotate the tip. Is this so? My nose is overprojected and large, in general, I am worried that if only the hump is removed, the nose will appear long in profile view. My question is, how is a nose shortened (not de-projected)...is rotating the tip and risking a "piggy" look really the only option?
Is a Long Nose Shortened Only by Rotating the Tip?
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Changing nasal length
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Nasal Tip Rotation Rhinoplasty
Rotation of the nasal tip upward can give an illusion of shortening the nose, but that is only one component of correction of a long nose.
If your nose is long in the tip, it really depends. Sometimes the nasal tip is deconstructed and shortened like legs on a chair that are too long are cut off.
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Is a Long Nose Shortened Only by Rotating the Tip?
Yes a long nose has a downward rotated nasal tip. Rotating the tip up will shorten the nose but this is different than tip projection. Projection is how far, off the face, the tip extends. If over-projected, the tip would need to be decreased as a separate issue to tip rotation.
Shortening the Nose & "Piggy-Look"
With careful pre-op planning you will not "risk" a piggy look - you and your surgeon will establish reasonable goals. If rotating the tip is not acceptable, there are ways to camouflage the actual nasal length. A natural result will be achieved if all parts of the nose are balanced and proportional. Your concerns are appropriate - if you provide pictures or I can examine your nose I will make specific recommendations.
Shortening a nose in rhinoplasty
There are several ways to shorten a nose. Rotating up the tip is one option, but it can leave an overly upturned appearance if rotated too much. Each nose is different and you need to consult with a rhinoplasty expert Facial Plastic surgeon. For example, if the nose is too long from the lip-columella point to the tip, rotating the tip will do little. Correction for this involves reducing the anterior septum, shortening the nasal spine (if needed) and even shortening the columellar portions of the lower lateral cartilage.
In other words, you don't have to have a "piggy" nose to have it shortened. Hope this helps.
Length, Projection, and Rotation
You bring up some great points. Reducing projection and reducing length are not the same thing. Rotating the tip is not the only way to shorten a nose. You can also shorten a nose by trimming the caudal septum. Also, lowering the dorsum and reducing tip projection can both help reduce the size of your nose, but not necessarily the length of the nose. It's difficult to comment on what maneuvers would give you the best result without photos, and without knowing what your goals are. A successful rhinoplasty involves planning out a combination of maneuvers to acheive a specific agreed upon aesthetic result. Even a subtle change in the appearance involves a series of technical maneuvers. It sounds like what was recommended to you was reducing the hump, reducing dorsal projection, and rotating the tip. Depending on what you look like, this may be a reasonable approach to your problem, and would not necessarily give you a "pig nose". My best advice would be choose a Board Certified Plastic Surgeon or ENT/Facial Plastic Surgeon with experience in Rhinoplasty, and be very clear about your goals. A good idea is to write down 3 things that bother you the most about your nose, in order of importance, and share that with your surgeon. Good luck!
Shortening the long nose
There are several ways to shorten a long nose, tip rotation, reducing tip projection, and septal shortening. The tip need not be over rotated or up turned. Computer imaging can help demonstrate just what is causing in 'length' and give insights into the fix needed.
Best of luck,
Rhinoplasty to shorten the nose.
Rhinoplasty and nasal shortening
Nasal length can be addressed by three different means: lowering the dorsum, which brings the radix (root of the nose that exists between the eyes) lower, rotating the tip, and shortening the caudal septem and anterior nasal spine.
In 2011, photographic morphing is a standard to help patients envision their nose, and also allow you and your surgeon to more effectively communicate about what you want and don't want. This is essential.
Rhinoplasty is a difficult surgery and is most likely deeply discounted by less experienced surgeons, so don't pick your surgeon by the lowest price. You should consult with a few highly regarded surgeons that are expert in rhinoplasty who are either certified by the American Board of Plastic Surgery or the American Board of Facial Plastic Surgery. These surgeons should be excellent at communicating what they would do for you while you both view and morph your photographs together, and you should feel comfortable with their demeanor. Additionally, you should view their before and after photographs looking at patients with a similar nose as yours.
Best of luck!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.