Hi I am a male with too much nostril show from the frontal view. Derotating the tip however would lengthen the dorsum and my dorsum would be too long if this was done. Is there another rhinoplasty technique which could improve my situation? Would very much appreciate any advice. Kind regards,
Too Much Nostril Show (Male). Best Technique?
Doctor Answers (11)
Don't worry about technique, worry about your surgeon
I would be very careful deciding on a technique before you decide on a surgeon. Meet with someone with a good reputation (preferably a few if you really want to be careful), have them do computer imaging to show you what they can reasonably do, and go with your gut. Surgeons handle problems in different ways by influence of their training and experience. There is more than one way to skin a cat!
Reducing nostril show
Reducing nostril show can be done through a variety of techniques, such as augmenting the nasal bridge, dropping the nasal tip, reducing the cartilaginous dorsum, or tucking in and trimming back the inferior-most portion of the caudal septum. Both the membranous and cartilaginous caudal septum can be trimmed back to derotate the tip.
Male nostril show
When one alters the nasal ala all other components of the nose may change in proportion. For example, the tip may seem much larger, or more round and distorted. The whole nose must be considered whenever changing one aspect. You should seek on office consult with a board certified plastic surgeon for information specific to you. Good luck.
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It is very difficult to answer your question without seeing your pictures – you should consider posting images showing your areas of concern
Male with to much nostril show
I have performed Rhinoplasty for over 20 years and to much nostril show is just another way to describe an over rotated nasal tip...photos would help. If you do not want the tip rotation adjusted there's another way to give the nose the illusion that it has been rotated downward. It's called a columellar tuck which does not require a formal Revision Rhinoplasty and is performed along the anterior, inferior septal angle. Hope this helps.
There are several techniques which might suit you. Without photos it's hard to pick one. I suggest you have a consult with computer imaging which might better help you define what you are looking for.
Nostril show on frontal view
alar rim grafts can add length to the rims and help decrease your nostril show, it can be done without obvious incisions.
Rhinoplasty of filler
As you can see there are a number of ways to approach this problem but without photos it is very difficult to say definitively what would be best for you. I would highly recommend that you consult at least one plastic surgeon in your area that has rhinoplasty and filler experience so that you can get a result you will be happy with.
Rhinoplasty to Narrow Nostrils
A simple diamond shaped excision of tissue at each nasal sill will narrow the nostils from frontal view and have no effect on the length or rotation of the nose.
Nostril Show Reduced By Chondrocutaneous Grafts
Too much frontal nostril show can be reduced through alar rim grafts, particularly a composite chondrocutaneous graft. This can lower the alar rims a few millimeters without having to derotate the tip and perform an open rhinoplasty. Cartilage rim grafts alone would likely not be enough as you need the alar rim skin rolled out. This would needed to be maintained by the skin from the chondrocutaneous graft. You could test out if that concept creates the look you are after but having temporary fillers placed first.