Do dorsal onlay grafts help with borderline piggy noses?

Dorsal onlay grafts are typically used to increase the height of the dorsum (dorsal augmentation) or smooth out the dorsum. In your case, it sounds like you have a short nose and overrotation of the tip allowing for excess nostril show. If this is the case, you may require techniques that derotate the nasal tip and lengthen the nose (e.g., caudal septal extension graft, extended spreader grafts). Additionally, you may also need techniques that lower the nostril rims (e.g., lateral crural strut grafts, alar contour grafts). You would probably find it beneficial to consult with a board certified plastic surgeon that performs rhinoplasty frequently to discuss your concerns and possible options to address them.

A dorsal onlay graft alone would unlikely resolve the upturned nasal tip.  There will likely be need for caudal septal work and possible revision work on the lower lateral cartilages.  A consult with a local plastic surgeon that performs rhinoplasties will be your best option.  Good luck and be safe.John T. Nguyen, MD, FACS, FICSDouble Board Certified Plastic Surgeon

Dorsal onlay grafts can be placed on top of the nasal bridge to build it up. A stronger looking bridge will make the nasal tip look less up-turned. The grafts are usually cartilage take from the nasal septum and occasionally from another location depending on the need. The most important step is analyzing the nose and developing an appropriate treatment plan.  You should consult with a surgeon experienced in rhinoplasty.  Good luck,Dr. Kaniff

The piggy nose - dorsal onlay grafts do not help. You would need a graft to extend both the central portion of your nose as well as the  AL AE. See a very experienced rhinoplasty surgeon for this as this needs the same expertise as a revision rhinoplasty. You will be able to find examples of this on my website under revision rhinoplasty.

Over rotated tips can be difficult to treat.  Grafts can be used to rotate the tip down a bit to derotate it.

You will get the best answer from a consultation with a plastic surgeon who is comfortable with revision rhinoplasties. However, an over-rotated or "piggy" nose can be corrected with a caudal septal replacement graft or extended spreader graft.  Keep in mind that the amount of de-rotation that can be achieved can be limited by the elasticity in the nasal skin.  

Difficult to say if an onlay graft can treat the over-rotated, pig nose.  I think it is more the caudal septal extension graft or extended spreader grafts that make the difference.  However, like all things rhinoplasty, this is on a case by case basis. 

The piggy type upturned nose can be corrected and I have done so many times. Obviously a full examination is needed before I can fully inform you what technique I would use. I would take your photos though after that exam and alter them digitally with your input so you could be fully informed about the procedure you are seeking and clearly show me the changes you are looking for.

Dr. Corbin