Derotation and lengthening of the nose - are they the same thing?

Question

I had a rhinoplasty 1 year ago and it's too short I think. But how do I know if it's too short or too rotated; are the the same thing, with the same solution/s? Thanks!

Thomas A. Lamperti, MD · Answer

Technically nasal derotation and lengthening are separate things, though by derotating a tip you are lengthening it. You can also lengthen a nose by making the tip more projected (stick out more). In your situation what's important is to assess your current tip rotation and projection to see if they are appropriate. By visiting a rhinoplasty specialist you can better assess this.You can learn more about upturned nose treatment at my web reference link below.

Mario J. Imola, MD, DDS · Answer

When analyzing a nose it is important to be precise and specific with terminology.  Most nasal analysis systems use the following definitions:
  
Nasal Length - The distance from Nasion (the break point where the base of the forehead intersects with the nasal bridge) to the Tip Defining Points (the fore-most and down-most positions along the nasal tip profile - this can vary from very distinct to indistinct depending on the curvature of angularity of the tip).  
  Tip Rotation - The position of the tip in space relative to the nasal base.  This is often measured using the angle subtended by the columella and the upper lip also known as the naso-labial angle. The larger the nasolabial angle, the more up-rotated the tip is.  In order to avoid ambiguity it is a good idea to speak in terms of down-rotation and up-rotation. Notwithstanding, most surgeons use the term 'derotation' to refer to down-rotation.  
  Tip Projection – The distance the Tip Defining Points extend forward from the face.
  Nasal length, tip rotation and tip projection are inter-related.  Modifying tip rotation will have an effect on both tip projection and nasal length.  If tip rotation is kept constant, then modifying tip projection will result in a proportionate change in nasal length.  
  
In summary then, derotation or down-rotation of the tip results in an increase in nasal length plus a decrease in tip projection, and therefore, the two are not the same.   
Mario J. Imola, MD, DDS, FRCSC, FACS.

Jeffrey Jumaily, MD · Answer

The rotation and length are not the same thing but may lead to the same appearance. The rotation is the angle between the nose and the upper lip. The length is the distance from the radix (upper part, where the nose starts) and the tip. An overrotated nose can look short which may be is what you are seeing. A consultation is very helpful to determine the causes and discuss solutions. Best wishes

William Portuese, MD · Answer

No, they are not the same thing. De-rotation of the tip simply means bringing the tip downwards. Lengthening the nose can include projection of it as well as adding vertical length. Best to talk to  your prospective surgeon about what you're trying to accomplish. Digital computer imaging may also be helpful.

Richard W. Fleming, MD (retired) · Answer

There are multiple possible causes of a short nose including over rotation. Treatment will vary depending on the your particular needs.

Derotation and lengthening of the nose - are they the same thing?

Answers (5)

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