Upturned nose 9 days post-op on closed septo-rhinoplasty, will the tip adjust?

Doctor Answers 5

Early post op tiurned up nose

Don't panic about a turned up nose in the first several weeks since a few temporary things are at play: 1] the taping process [which is necessary to squeeze swelling out of the supra-tip area and to keep the tip domes together] will hold the tip artificially turned up for a while till it settles back down. 2] There is usually a fair amount of swelling at the junction of the upper lip and the columella / nostrils...this swelling makes the angle between the lip and the nose look obtuse and turns up the nose. Having said that, if you persist after 6 months with an overly rotated or turned up nose and nostril show; please read my following answer to another “Real Self” question about this problem:

Although the overly rotated tip is congenital in some people, it ican be the consequence of the surgeon not recognizing that reducing the hump or bridge along with the standard procedure of trimming the upper edge of the wide tip cartilages results in loss of the support system that was keeping your nose from being too turned up. If the septum is shortened at its caudal [lowest] end the same thing can happen. Certainly this is not a primary concern if you have a droopy tip to begin with, but if you already have a borderline open angle between the upper lip and the columella and borderline too much nostril show...you end up with a Miss Piggy nose. Not a flattering term but your distress is palpable and you need to know there are specialists who have devoted themselves to this specific problem. I have over 25 years of experience de-rotating the tip and depending on the cartilage available and how much internal nasal mucosa can be stretched...at least a partial and perhaps an elegant lengthening of your short nose will happen. By the way...just to not be confusing...length is the vertical distance when standing from the upper point between the eyes where nose begins [separates from forehead] to the tip at its most projected aspect. Sometimes the tip will come down and the nostrils still flare and appear too arched and, therefore, a simultaneous borrowing from the ear [with typically not obvious scar] of a composite graft of skin adherent to cartilage must be placed inside the nostril rim to lower this area as well. As you can tell this is very sophisticated surgery and the doctors with experience and devotion to the nuances of this surgery are few and far between. I prefer to do this procedure closed and others do it through an open approach. I prefer not to scar the columella and since this columella is bearing the stress of the lengthening tension...I think it should not be cut. The most important thing is that you see results from the surgeon solving the exact problem and solving it with artistry.

Sacramento Plastic Surgeon
4.5 out of 5 stars 9 reviews

Upturned tip

Nose tip projection does decrease somewhate after a rhinoplasty and this can correct an upturn of the nose.  It is best to be patient for now and allow swelling to completely resolve.  Best wishes, Dr. T. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 52 reviews

Upturned tip after rhinoplasty

The amount of tip refinement and definition will increase as the swelling resolves.  The tip rotation (how upturned it is) will also improve - as the swelling decreases the tip will drop a bit.  By about 3-6 months post-op enough swelling will have resolved for you to have a good idea of whether you will be happy or not.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 58 reviews

9 days post op, some advices

Thank you very much for enquire. It's too early to make value judgments with only nine days after a rhinoplasty.
Swelling after a rhinoplasty depends of the surgery complexity.
In this regard, the nasal swelling Post-op It can last from two weeks to two months.
To reduce this swelling, I recommend you perform delicates daily lymphatic drainage massage therapy over the face (around the nose) avoid sun exposure, and take pain/inflamation pills, as your surgeron precribe you.
Kind regards, 
Dr. Emmanuel Mallol Cotes.- 

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 270 reviews

Upturned nose 9 days post-op on closed septo-rhinoplasty, will the tip adjust?

Hello Journey to Yes,You will notice that at only 9 days since your surgery you will continue to notice many changes.  Frequently the nose is slightly turned up from the swelling and would be expected to drop by a few millimeters as the swelling goes down  Continue to follow up with your surgeon and express your concerns as he or she knows what took place during surgery, but right now it is important to be patient.I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.