Possible upper lateral cartilage reduction? Thoughts? (photos)

Question

Hello, I’m interested in getting my nasal tip rotated, ideally to form a 106 degree nasolabial angel. I’ve also noticed that my upper lateral cartilage may be somewhat large, and I think reducing that would be necessary to rotate my nose up. Can nose tips be rotated upwards by removing this excess upper lateral cartilage? If it is, is the remaining upper lateral cartilage then sutured to the nasal bone, essentially pulling or “lifting” up the tip by doing so? Hope that made some sense

Matthew Bridges, MD, FACS · Answer

Please take this advice with total respect.  You clearly have thought alot about your nose.  I think you are thinking TOO much about.  Rather than trying to figure out what needs to be done surgically to your nose, i recommend that you think about what changes you would like to make to your nose, then let a rhinoplasty expert take care of the specific surgical moves necessary to achieve those changes. When you go see a rhinoplasty surgeon and say you want to get your rotation to 106 degrees, that's a major red flag.  First off, that is WAY too rotated for your nose.  Second, rhinoplasty is not engineering (i bet you are an engineer).  It's living tissue modification.  There's a lot of art to it.  There is no way to achieve specific angles in real life.  Go see an expert and do computer morphing and go from there.  Good luck!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty and a cephalic rotation of your tip to turn up your tip slightly.  Tip rotation is performed with angulated caudal septal trim and placement of a columellar strut graft rather than suturing the upper lateral cartilage.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. 
 
 Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Possible upper lateral cartilage reduction? Thoughts? (photos)

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Possible upper lateral cartilage reduction? Thoughts? (photos)

Answers (2)

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Everything you need to know about Rhinoplasty

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