Do I need septum lengthening? (Photo)

Question

My desired results are below. Is the nose that I desire possible with my nose frame? I've consulted with one doctor and he said my nose angle was really wide and I would need my septum lethening via graph. What techniques would you use to get my nose to my desired look?

Juan Carlos Fuentes, MD · Answer

I agree with Dr. Portuese. You do not need to length your septal cartilage, you need to reduce the small hump on the bridge of the nose, reduce the hanging columella and the alar retraction. You will need some cartilage grafts to stabilize the cartilage framework and the grafts will be harvested from the septal cartilage.

Anand G. Shah, MD · Answer

Hi Emc.  Please understand that the definitive answer rests with an in-person consultation and examination.  Upon reviewing your photos, you appear to have excessive columellar show.  Your tip may also be over-rotated.  Grafting is required; however typically septal extension is not used to address columellar show.  If you like, please reference the article below on Nasal Analysis.  There are useful diagrams that may help guide your decision making process.Hope this is helpful.Best wishes.Dr. Shah

Barry L. Eppley, MD, DMD · Answer

You need tip lengthening and derogation. This will require multiple cartilage grafts in the tip and nostril rim area to achieve these changes, one of which would be a septal lengthening graft.

William Portuese, MD · Answer

The photographs demonstrate  excess columellar show and a dorsal hump, both of which can be addressed with a closed rhinoplasty approach as an outpatient surgical procedure. Patients who have a columellar show do not need septal extension grafts

Richard W. Fleming, MD (retired) · Answer

A cartilage graft attached to your septum will be needed to lengthen your nose and decrease tip rotation. Grafts will also be needed to lower your retracted nostril rims.

Do I need septum lengthening? (Photo)

Answers (5)

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