Can you shorten an over projected septum and can you fix a crooked tip?

Question

I have pulled at my nose for years and have pulled it down and out of place, my septum is now too long for my face as well as being completely moved to the right, so much that both sides of my nose collapse in when I breathe in, my tip has become deformed and is now too far from my face and also pushed to the right

Lucian Ion, FRCS · Answer

Before contemplating surgery, you need to feel comfortable that you are no longer attempted to traumatise the nose. This would destabilise the outcome of surgery and could actually end up looking worse than before your operation.
By and large, a reduction in tip projection and reshaping of the nasal tip are generally possible and it is mostly a matter of the degree of change that needs to be clarified and planned. Computer simulations can help with this, but the outcome of surgery is never identical to the simulations.
In general, contouring the nasal tip can benefit from cartilage grafts that support it.

Edwin F. Williams, III, MD · Answer

These can certainly be accomplished by rhinoplasty as these are among the most common concerns with patients presenting for rhinoplasty consultation. Make sure and seek consultation with an experienced, board-certified surgeon to optimize your results. Best of luck!

Gary Linkov, MD · Answer

Rhinoplasty requires exceptional skill on behalf of the surgeon and great communication with the patient about realistic goals and expectations. Common cosmetic concerns include a dorsal hump, wide nose, sunken nose, irregularities, and asymmetries. Functional concerns include difficulty breathing through the nose, which can and should be addressed at the same time as your rhinoplasty.

In your situation, we would need high quality photos to make a recommendation.

Find someone you connect with, who will listen to your concerns and provide you with a framework for what is possible.

Gary Linkov, MD 
Rhinoplasty Specialist 
Manhattan

Behrad Elmiyeh, MBBS, MRCS, FRCS (ORL HNS) · Answer

Thank you for your questions.
Rhinoplasty is frequently performed in combination with Septoplasty (called Septorhinoplasty) to correct a deviated nasal septum (the cartilage in the nose that separates the nostrils) causing a blocked nose and/or to harvest septal cartilage and use it as a graft to improve nasal support or shape.
Septorhinoplasty can alter both nasal and septal length and shape.
This is one of the most delicate and complex cosmetic surgeries, given the intricate structure of the nose and the balance it provides to a face.
It is a common misconception to think that the nose can be sculpted as if it was a piece of marble or that one can choose a “perfect” celebrity nose from a magazine. 
There are limitations based on the individual's intricate nasal anatomy and nasal skin quality. For example, a thick nasal skin is great in covering up minor irregularities but since it does not shrink well after surgery, it will not show fine underlying refinements.
I would suggest that you consult with an expert rhinoplasty surgeon and discuss what you do and do not like about your nose.
You should expect a full detailed examination of your nose is required to assess your nasal skin, cartilage, bony structures, and your nasal airway/ breathing. This will allow the surgeon to evaluate your nasal appearance and its relation to your facial features.
The use of manipulated (morphed) digital clinical photography provides a platform for discussion as to your desires and expectations. Such images are not a guarantee of exact results, but a great tool to ensure that you and your surgeon are on the same wavelength.
It is paramount that you have a realistic expectation before proceeding with this surgery.
Best wishes,

Victor Manuel Agudelo, MD · Answer

Your concerns expressed can usually be corrected with a rhinoplasty, but pictures will be necessary for a better evaluation of your case. I suggest you to book a virtual or in person consultation where you can share additional photos and get a better advice from your doctor.

Can you shorten an over projected septum and can you fix a crooked tip?

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