How Can I Fix my Turned Up Nose?

A short and overly upturned nose can give an unnatural appearance to the nose. Short noses typically have too wide of an angle between the nose and the upper lip. In an ideal nose, this angle (called the nasolabial angle) is in the range of 95- 105 degrees for women and 90-95 degrees for men. Correction of a short and upturned nose typically requires changing the framework of the nose to make the nose appear longer. The intended result is a nose that is more harmonious with the rest of the face and has a natural and aesthetically pleasing angulation.
This young woman felt that her nose was too upturned and wanted a more natural and softer appearance. After rhinoplasty surgery the tip of the nose is not lifted up as much and appears less prominent and more feminine in appearance. Less of her nostril is visible.
http://www.seattleface.com/html/before_n_after_set.php?procedure=primary_rhinoplasty&id=16
Here is another example of an overly turned up nose with excessive show of nostrils that was improved with a primary rhinoplasty:
http://www.seattleface.com/html/before_n_after_set.php?procedure=primary_rhinoplasty&id=14

Correction of the turned up nose is one of the more difficult challenges seen in rhinoplasty surgery. The problem occurs because the nasal tip is rotated in an upward direction. This ultimately increases the angle between the lip and the nostril which leads to increased exposure of the nostrils.
                Correction of this problem involves decreasing the angle between the nose and lip. This is accomplished with a variety of maneuvers that are designed to lengthen the nose. In most cases this involves some type of cartilage grafting. The exact procedure chosen will depend upon the patients specific anatomic findings.

                If you’re considering correction of your turned up nose, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals. 

From the description, it sounds like the best option to correct these issues is rhinoplasty.  This can be accomplished by counter-rotating the tip so that the nostrils do not show as much on frontal view.  If your bridge (dorsum) is overly sloped, augmenting this area also may be necessary.  A detailed exam would be necessary to formulate a plain specifically for your anatomy, but it would generally involve cartilage grafting and suture techniques.  Fillers are not a good long term solution to this problem.  See a rhinoplasty specialist who can evaluate your anatomy and go over photo simulations to make sure you have the same shared goal in mind.

The situation is a little more challenging than the standard rhinoplasty with a dorsal hump. If you have never had rhinoplasty then this is probably due to a congenital short nose. Cartilage grafts can be used to lengthen the nose or just the tip if that is all that is needed. The cartridge can be harvested from the septum which is the dividing wall between the nostrils. This may be a situation where a closed rhinoplasty is better since the placement of the grafts places tension on the skin of the nasal tip. This would place tension on the suture line in the open technique. A careful assessment by an experienced rhinoplasty surgeon is essential in order to get the best advice. Photographs would be helpful.

There are a number of different techniques to fix an upturned nose.  It would be very difficult to describe exactly how the different procedures are done, but I use an open rhinoplasty approach to allow the tip of the nose to be derotated so that the nose is a bit longer and the nostrils are less visible.  

What you are describing is over rotation of the tip in the only correction for this is with nasal surgery.  Fortunately, this can be addressed using common rhinoplasty tip technique.  Sometimes an overly rotated tip and a low bridge may require nasal lengthening techniques such as extended spreader grafts or septal extension grafts.  

Rhinoplasty will be your main option with what you are describing. The surgery will likely require adding cartilage to the bridge and reconstructing the tip to lengthen it and improve the nostril show.

There are a variety of rhinoplasty techniques for fixing an upturned (over-rotated) nose. The basic principle is to bring the tip of the nose down, restoring a more normal angle between the upper lip and the nose. This angle should be 90-95 degrees in men and 95-105 degrees in women, ideally.

The tip can be counter-rotated by shortening the medial crura of the tip (lower lateral) cartilages, which sit behind the columella, the portion of the nose between the nostrils. This maneuver, called a medial crural overlay, will also reduce the projection of the nose, the degree to which it sticks out horizontally. from the face. 

Another commonly used technique in rhinoplasty is to place extended spreader grafts, long straight pieces of cartilage which are sutured to the septum and push the tip downwards. These grafts may be taken from the septum or from rib cartilage, if the septal cartilage has been previously utilized. 

Visibility of the nostrils should improve with the techniques I mentioned above. Additional maneuvers, such as the placement of  rim grafts, can also lower the nostril rims. 

There are no effective non-surgical ways to counter-rotate the nose and reduce the visibility of the nostrils. If your issue were simply building up your bridge to make your nose appear less scooped, this may be achieved with the use of filler, however, I would caution you to avoid any permanent fillers in this area. 

Best of luck,

Dr. Mehta

Fixing an upturned nose requires advanced rhinoplasty techniques to improve the overall appearance of the nose.  While there are some limited applications of nonsurgical rhinoplasty, this is definitely not one.  Seek a surgeon with experience in revision rhinoplasty who will work with you on creating a nose image which works with your facial features.

There are no nonsurgical methods to fully address an overly upturned nose. There are surgical techniques available to improve your problem, though.  To decrease how upturned your tip is (decrease tip rotation) your nose must be lengthened which is often done using grafts. This can take the form of cartilage grafting (septum, ear, or rib cartilage) to push your tip down and bring your nose into a more natural-appearing alignment.

An over-rotated nose can occur naturally or as a results of overly aggressive reductive rhinoplasty. Correcting a post-surgical overly upturned nose is made more difficult by the scarring of the overlying skin which impedes movement of the tip downward. Structural cartilage grafting techniques will allow your surgeon to counteract these forces and maintain the new tip position.

There are many ways to reposition the angle of the nose, depending on whether or not you have had previous surgery and the amount of cartilaginous support in your nasal tip.  This is a very common problem and there are many ways to improve an upturned tip.