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
Rhinoplasty to Bring Down the Tip and Columella
Doctor Answers (7)
Lengthening the Nose
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.
Unusual Alteration Request
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"
Rhinoplasty to lower tip and columella
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.
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Customized tip rhinoplasty
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.
Dr. Torkian - Lasky Clinic Beverly Hills
Your tip and columella can be turned down with more nostril show.
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
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.
Getting your results
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.