Can short nose, upward tip, columella & nostrils be brought down under local anaesthetic?

Question

Before revision, my tip was over rotated, upwards, with a high columella & excess nostril show. It looked unattractive & unnatural. I had revision over a year ago. It’s improved. But the tip + columella are still high up &nostril show. I also have a line above my upper lip when I smile. I’ve been told this can all be fixed under local anaesthetic - stitches under the lips, to adjust the columella graft. The nostrils can also be adjusted. Is this common? Is it possible? How?

Gary M. Horndeski, MD · Answer

It is most likely that you will need a cartilage graft over the dorsum of the nose to bring your tip down.  You will need this done under general anesthesia.

Best Wishes,

Gary Horndeski, M.D.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question. As far as I can see from your photos your columella is still hanging and tip of your nose is over projected. Also due to that issues your nose seems really short. For gain more elegant, natural looking I recommend you revision rhinoplatsy surgery. If you can provide photos with better lighting, from the front of your face and 1 meter away I would be able to make a proper evaluation. It would be more convenient to decide with face-to-face consultation. Best Regards!

Eric M. Joseph, MD · Answer

In our experience, gaining Tip lowering with revision rhinoplasty may require either a septal extension graft or extended spreader grafts. Would be a most complicated nasal septal reconstruction, I do not see how this could be performed with local anesthetic. Thank you for this question. Sincerely, Dr Joseph

Can short nose, upward tip, columella & nostrils be brought down under local anaesthetic?

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