Tip derotation possible in revision?

It is possible to achieve rotating the nasal tip backwards to where it was.  It usually involves grafting using cartilage from either the ear, nasal septum or the rib.It is difficult surgery especially when done as a revision surgery.RegardsDr. J

Hi.  Yes, derotation of the tip is possible, but it is more difficult things we do.  All revision rhinoplasty's are difficult but ones in which you need to lengthen the nose a bit are some of the most difficult of all. Depending on how much cartilage was removed at your initial surgery, rib cartilage may need to be used.  It is very important in this kind of a revision rhinoplasty you find a surgeon not only experienced in revision rhinoplasty but one  who is experienced in derotating the tip, and has experienced using rib cartilage. Good luck.

 Revision rhinoplasty is one of the most difficult procedure to perform and the entire field of cosmetic surgery and tip de- rotation is extremely difficult. It's also best to wait at least a year before undergoing elective revision rhinoplasty to insure full healing has occurred. A hanging columella is decreased with a columella-plasty

Tip rotation can be decreased but this may or may not be the best approach for you. Other possible techniques include the addition of tip grafts or the use of septal extension grafts. An experienced revision rhinoplasty specialist will use all of these approaches depending on the needs of each patient.

Without photos it is not possible to comment on your specific situation. Tip derotation is certainly possible. The issue with derotation centers around the degree of derotation necessary and the condition of the nasal skin and lining (mucosal surface). Options vary from dissection and a small cartilage graft to bone grafts and free tissue transfer to restore skin and/or lining.