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Rhinoplasty to Bring Down the Tip and Columella

I have an upturned nose and am interested in a tip rhinoplasty to bring down the tip and make the nose appear longer. My ideal is to have a defined and slightly "droopy" nasal tip with a bit of a hanging columella and minimal visible nostril, the photo is an example. A plastic surgeon told me she wouldn’t want to bring the tip down to even a ninety degree angle and that anything past that is masculine. Would most plastic surgeons be uncomfortable giving me the results i want? Thanks

Doctor Answers (7)

Lengthening the Nose

+1

On the basis of the photo you submitted I would not want to lengthen your nose and give you more of a hanging columella. I might feel differently if I examined your nose. This is a perfect example of why patient and surgeon should carefully discuss the goals and expectations of surgery.


Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Unusual Alteration Request

+1

I would agree that most plastic surgeons who perform thoughtful rhinoplasty would not deliver the results you want.  I believe our job as plastic surgeons is to use are surgical ability and medical knowledge to help patient achieve their desired results WITHIN reason.  Different plastic surgeons have different thresholds on "REASONABLE"

Good Luck

Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Rhinoplasty to lower tip and columella

+1

Rhinoplasty of the nasal tip may achieve a longer, downward pointing tip, if that is what you wish. The aesthetic result may not be desirable for the plastic surgeon with whom you have consulted, hence her hesitation in performing the surgery. 

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 5 reviews

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Customized tip rhinoplasty

+1

While Rhinoplasty can be customized to the desired shape and specifications you desire as a patient, many times what you would consider ideal may not look as you would like it when it is on your face.   This is why it is extremely important to have your images morphed by an experienced rhinoplasty surgeon during a real consultation.  

Since you have not posted your own photo, it is difficult to tell what procedures need to be done during your rhinoplasty to decrease your nasolabial angle, and lower the position of your collumella.  These changes can be achieved, however, with a septal extension graft, and possibly extended spreader grafts to help change the septo-collumellar relationship.

You can see some examples of this in my website's photo gallery in the "short nose" category.

Good luck.

Dr. Torkian - Lasky Clinic Beverly Hills 

Behrooz Torkian, MD
Beverly Hills Facial Plastic Surgeon
4.0 out of 5 stars 8 reviews

Your tip and columella can be turned down with more nostril show.

+1

Your tip and columella can be turned down with more nostril show. But why do you want to do that? What do your pictures look like now.

Usually, patients with a nose like the pictures you sent want to have the tip and columella raised. But with cartilage grafts the tip can be brought down and the columellar show increased.

Have your surgeon show you possible changes on the computer before the surgery so you're both 'on the same page'.

G. Gregory Gallico, III, MD, FACS
Associate Professor, Plastic Surgery
Massachusetts General Hospital
Harvard Medical School
170 Commonwealth Avenue
Boston, MA 02116
Tel: 617-267-5553
Fax: 617-267-5507
ggallico@partners.org
 

G. Gregory Gallico III, MD
Boston Plastic Surgeon
3.5 out of 5 stars 3 reviews

Rhinoplasty

+1

The photos you present do not show an upturned nose.  Yes, your chin is pointing down in the photos a bit so that may dsitort things, but your tip looks too down already.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Getting your results

+1

Thanks for the EXCELLENT photos. It is a difficult concept to give exactly the desired results. I think you can achieve the result you wish but you need in person evaluations not over the internet. Seek additional opinions. I think I could get that result but you need to find a PS in your area. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

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.