What grafts are required to increase projection and length in a revision rhinoplasty, and is this possible? (photos)

Question

I really wanted a subtle result, like the computer image I made, but my actual result changed my upper lip and my nose also looks too short for my face now. My septum was shortened and my nose was deprojected and I think this caused the upper lip change. I liked my upper lip angle better before and I used to have more tooth show. Can a septal extension graft restore my original nasolabial angle and lengthen and project my nose to look like computer image?

Bradford A. Bader, MD · Answer

I can certainly see your concern. The nose has been shortened and the tip has lost definition. This will happen if the tip is not stabilized during primary rhinoplasty. This can be improved with a septal extension graft, which will lengthen and counter-rotate the nose. You might require additional grafting at the tip to regain some definition. I recommend consulting with an experienced revision rhinoplasty surgeon.

Minas Constantinides, MD · Answer

When the septum is shortened inferiorly, close to the upper lip attachment, then the nasolabial angle is decreased and the lip can retract posteriorly and superiorly. This may cause the lip to also become more vertical, causing less upper tooth show with smiling.Your tip rotated after surgery, shortening your nose. This can occur when the anterior septal angle (or the most anterior portion of the septum) is reduced, when the the top of the nose is lowered, and/or when the lateral crura are make less wide. Certain sutures used to narrow the tip also cause rotation. A septal extension graft is one way to correct some of these issues by forcing the tip to counter-rotate and by filling the inferior septum near the upper lip. There are many other ways to achieve nasal lengthening, such as plumping grafts in the nasolabial area, infratip lobule onlay grafts, dorsal grafts, etc. See an experienced revision rhinoplasty surgeon for a full analysis and discussion of your options.

Dennis Barek, MD (retired) · Answer

I think the aesthetics of your nose and lip are good. I would not recommend revision surgery. You cant get much better, but you certainly risk getting worse.

What grafts are required to increase projection and length in a revision rhinoplasty, and is this possible? (photos)

Answers (3)

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

What grafts are required to increase projection and length in a revision rhinoplasty, and is this possible? (photos)

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.