I'm looking to get a revision to make my nose more longer and roman like as it was before.I had a hump reduction and my nostrils and tip were reduced. My doctor also raised the tip.My question is when the tip is raised,are the nostrils usually shortened as well?Would my revisionist need to bring down the nostrils to match up when the tip is de-rotated?
When the Tip is Rotated Up Are the Nostrils Shortened Too?
Doctor Answers (5)
Nasal tip rotation and effect on nostril shape
The nostrils move up and down in rotation with the tip and are not typically shortened. The only time that the nostrils are narrowed is through alarplasty incisions when the nostrils are quite wide. The alarplasty procedure is done independently of raising or lowering the tip.
Derotation of the nose tip and nostril dimensions
De rotation of the nasal tip may actually correct the nostril position and width ratio. The secondary problem is whether the columellar show and nostril show will change proportions.
In my experience, de-rotating the nasal tip, what you seem to be talking about, can make the nostrils look a bit longer. It changes the shape of the triangle. As the tip is de-rotated, the nostrils will come down with it; they are part of the tip complex. Sometimes, however, the cartilages of the tip, the lateral crurae, may need to be de-rotated separately and set in place with cartilage grafts called alar strut grafts. This can be a fairly complex maneuver and should be done by a surgeon experienced in such issues.
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When the tip of the nose goes up in rhinoplasty the nostril walls often follow.
It is difficult to tell exactly what you are referring to when you say nostrils. Nostrils can be reduced in width by an alarplasty but they also change position and shape by tip manipulation. The nasal tip needs to be treated as a unit. Bringing the tip down may require more grafts to also lower the nostril rims. This is called treating alar retraction.
A good revision rhinoplasty specialist will discuss all the things that need to be addressed to obtain a balanced result.