I'm seeking to turn my nose downwards to cover the nostrils a bit. They said they could not use a long implant because it would protrude and at best I would have a bulb at the end of my nose. How would you go about changing this nose so it projects more, is longer, and turns the nose down a few more degrees? I would imagine lifting the sides of my nostrils might help, but would my lips just pull it own?
Short Upturn Nose? (photo)
Doctor Answers 13
The tip in Asian Rhinoplasty
Often with a weak dorsal line and poorly defined.tip leads to the perception of a short and upturned tip. The flaring of your nostrils actually worsen this so the worst thing would to be to raise them. Adding a dorsal graft from your own tissue or alloplastic material will totally change this perception and lengthen the appearance of your nose. L struts are not my favorite because they leave the tip poorly projected and have a significant risk of infection and exposure. The Asian rhinoplasty is treated by adding material to reverse the depressed bridge and as you mentioned, lengthen and project the tip. My favorite way to do this is with autologous material which will also reduce the appearance of a long upper lip. Buy providing structure, the definition of the focal points of your nose will also be improved.
Treatment of Short Nose
Your nose can be lengthened with your own cartilage using a septal extension graft. Do not use an implant which usually is synthetic material. Your tip should be refined and projected with another cartilage graft. It is difficult to tell with this one picture but it appears that your bridge should also be augmented. You need a stronger, defined nose.
Correction of an upturned nose
The actual deformity looks more like a deficiency of the bridge of the nose. To correct this I recommend a rib graft to the dorsum . This will add balance and correct the upturned look.
Talmage Raine MD FACS
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Asian rhinoplasty to treat short, upturned nose
It is possible to improve your upturned tip. I prefer using your own cartilage to do this. This can involve using cartilage from your septum, ear or rib. The idea with using the cartilage is to create a stable base on which to reposition your upturned tip cartilages.
Lengthening the Asian nose
Essentially everything you've been told about the need for cartilage grafting of the tip are accurate. We would need to take cartilage from your ears or the septum of your nose to achieve this. Based on your nose you're most likely background is SE Asian, Philippines or your south China. Why does that matter? It makes it less likely that your septum will have good cartilage to donate, making your ear or ears the most likely site. You'll also need a dorsal graft on your bridge to build it up and make it appear longer, but yes, you don't want an implant to extend to the tip. In your case a synthetic implant or cartilage will do but you may run low on cartilage if we are only taking from your ear.
I utilize a lot of cartilage grafting as I operate primarily on Asians. It's be best technique.
Oh, on other thing. A cookbook maneuver that a lot of surgeons may offer is a nasal base reduction. Be conservative. It may not help you and can make for an unnatural appearance. It's a great technique and I use it often but only in the right patient.
As for your ear after surgery, it should look no different after the harvest so long as it's done correctly but mild deformity is always a risk.
Best of luck
Chase Lay, MD Cupertino, CA
Cartilage Grafting For Lengthening The Short Nose
Lengthening the short nose is a common issue in many ethnic rhinoplasties. Cartilage grafts are need to both lengthen the columella as well as drive the tip downward through septal extension grafts if desired. Grafts may also needed on the tip to help create this movement as well.. Such lengthening has also been done through an implant that is a combined dorso-columellar shape but it is never a good idea to use an implant to push the tip downward...that is a complication waiting to eventually happen.
Asian rhinoplasty with nasal augmentation
Dear Smurfy, the issues you are concerned about - short or flat nasal dorsum, up turned nasal tip and exposed nostrils - are common concerns in patients of Asian ancestry, who are considering a rhinoplasty. Either one's own cartilage or a nasal implant can be used to help correct these problems and each contains its own advantages and disadvantages. Available doner tissues and skin tightness/laxity would need to be evaluated before determining which type of procedure would be in your best interest. Regardless of what procedure you choose, be certain to ask to ask your surgeon to see before and after photos of patients who have had the procedure they are proposing. Best wishes.
Rhinoplasty nose surgery
- I like to use your own cartilage to lengthen the nose as well as add to the bridge if it is necessary for a great cosmetic outcome
- We would use cartilage from the septum (the wall that separates the two sides of the nose), and probably some from the ear if you needed extra height on the bridge (you would not notice any changes to the ear)
- Implants are used commonly in Asia, I just do not like them as they can get infected and I have had to remove them when they start coming out
- Going natural by using your own cartilage is my preferred method
Asian Rhinoplasty- Lenghtening the nose
short nose with an upturn of the nasal tip and lack of adequate nasal bridge is common among Asian and African American women who seek rhinoplasty in Los Angeles. Because most of these people do not have enough nasal septal cartilage to be used as a nasal graft, a nasal implant is instead used to add nasal bridge and to lenghten the nose.