Short upturned nose - how can I treat this? (Photo)

Great question! You are correct, in most cases we advise 1 year to allow things to heal and edema to settle. However there are cases, such as yours, where we can make exceptions. The timing in such scenarios is controversial and will depend on what the surgeon is comfortable doing. I personally feel that 6 months is adequate for such cases in order to avoid further skin contracture as you mentioned, and I have done this for patients within this time frame with great results. However, it would not be "wrong" to wait out the year to allow for more healing. One thing you can start doing now is massaging the nasal skin to allow for a release of contracture that has already occurred. In cases such as yours, it would be to traction / pull the skin of the nose downward and holding it for 1-2 minutes, 3-4 times per day. I have seen significant improvement in skin compliance and pliability with this method. The goal of your surgery will be to add structure and support to the framework of the nose, but making the skin more pliable will help to get the skin over the nose without tension, as well as to lessen its pull on the framework after the revision. Another very important key is to see surgeons that truly specialize in rhinoplasty and have experience with revisions. I hope this helps! Good Luck!

One thing to consider is that the tip can continue to drop some over the course of a year, which would result in less derotation that is needed. The skin shrinkwrap is something that occurs over many years, not just one. So waiting a year is usually the best thing to do. In cases of severe up turning, I have lowered that time to 9 months if I can clearly see no change between 6 and 9 months in tip movement. Be sure you are seeing a rhinoplasty expert for consultation.

The nasal tip tends to drop several millimeters over a 1 year healing period after rhinoplasty surgery. You appear to have a small, unobtrusive, and pleasing nasal appearance. I hope this is helpful. Sincerely, Dr. Joseph

Hello and thank you for your question. Based on your photographs, you are a good candidate for a revision to treat your over-rotated and over projected tip. Tip derotation and tip deprojection would be very helpful for you. I will consider this type of revision at eight months post-op, while other types of revisions require longer wait times. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon