My Nose is Upturned at the End, Which Method Do I Need?

Hello Doctor. I have got a upturned nose at the end. Im looking for derotation only. The bridge and the upper 2/3 seems to be ok to me. Which options do i have? And which surgical techniques may i need? It also have a bulbous tip, but it doenst really bother me. Derotation is the most important thing for me. Do i need to know something before consulting ENT with rhinoplasty knowledge and much experience in my country. I know there are three very good. Frank, Netherlands

Doctor Answers 4

Decreaasing Tip Rotation

There are several techniques to decrease tip rotation. Unfortunately, I cannot locate your pictures to evaluate your concern. The procedure can be as straightforward  as mobilizing your tip and placing a suture to fix your tip in its new location  or a  more involved placement of a cartililage graft. 

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Rhinoplasty de-rotation

Sometimes simples things can de-rotate the tip. This can sometimes be done by a complete trans-fixion o release at the juncture between the septum and medial crural cartilages.  Sometimes grafting can help as well.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Rhinoplasty techniques to correct upturned nose

One of the ways to help de-project and derotate the nose is to perform a dorsal augmentation with the patient’s own natural nasal cartilage. A full transfixion incision alone will also de-project the nose and allow the tip to droop slightly. In addition, the tip can also be slightly de-projected and derotated by placing a depressing stitch along the caudal septal margin to push the septum down. This can all be done through a closed rhinoplasty approach.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews


From the photos I would say that your nose is not upturned. If on a straight frontal view you can see right into the nostrils then it is upturned and that is not the case in the photos. What I do see is an asymmetric tip and prominent tip cartilages that create stepoff edges where they meet the bridge. Trimming of the upper edge of the tip cartilages and then suturing the 2 cartilages together to create a symmetric construct should solve the issue.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 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.