Can I get a more upturned nose without implants or grafts? (Photo)

Hello,Thank you for your question. A physical examination by an experienced Board Certified plastic surgeon could provide best options for you. It is difficult to evaluate your deviated septum from the provided photos. Ethnic noses require different approach, fine workmanship and skills. You may benefit from the straightening your nose, refinement of a tip and dorsal augmentation by my own technique using  the septal cartilage and bone dust obtained during the surgery. The Dorsal Roof Technique protects the dorsal anatomy but fixes the deformity and moreover, supports your dorsum by using the excessive tissue instead of excision. Breathing issues can be corrected as well. 
A beautiful and natural looking nose, that suits your face can be achieved by the help of the Closed and Atraumatic Technique in Rhinoplasty, which minimizes swelling and bruises, maximizes healing, prevents tissue damage and eliminates a scar on the columella. To find out more please click on the attached link.  
Best Regards 

Hello Elaine,Great question. The images you provided are not clear enough in order to properly address your concerns. A personal examination is needed. Please visit a board certified plastic surgeon for a detailed surgical plan to achieve your desired results.

 Rhinoplasty for a more up to her nose without using grafts or implants.  yes this is possible and frequently done. Cartilage is removed to bring the tip upward and other techniques can be used to support the tip etc. See a very experienced rhinoplasty surgeon who can show you natural long-term results of his work. Do not rely on Imaging. 

If you like the way your nose looks when pinch the sides, there is actually a quite simple procedure for that.  It’s called an alar wedge excisions.  You can google it and see many examples.  It works great, is simple and can be done under local anesthesia.  Even better, it costs much less. No grafts needed.  I do them frequently but many surgeons over look this procedure for more involved ones.  I don’t think you need cartilage grafts at all.

Hello and thank you for your question. I never recommend using an implant such as a silicone implant for rhinoplasty.  All your cartilage grafts can come from your own septum.  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
 

Thanks for posting your photos.  It's quite possible to achieve a more projected and refined nasal tip using cartilage harvested from your septum alone.  However, sometimes the septal cartilage is not sufficient or adequate for the structural grafts required.  Asians often have very weak and flimsy cartilage, sometimes there is not enough cartilage and sometimes the cartilage is bent and mangled.  An experienced rhinoplasty surgeon should always have a back-up plan, and usually this means either ear cartilage or rib cartilage.   Your nose needs to last your entire life, there are no short cuts.  Simpler options are not always the best option in long term.  Best have a formal consultation with an experienced Facial Plastic Surgeon specializing in Asian rhinoplasty.   Best wishes

Tip refinement can be done as long as you have enough cartilage from the septum to create the support to hold the tip up and create more shape/structure. This is why patients with smaller or shorter noses often require rib grafts where much more cartilage is available. It is best determined during your physical examination whether septal cartilage is sufficient to achieve your desired results. 
Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Yes, a tip can certainly be rotated without grafts or implants but whether that would be recommended for I can't say because there is no photo of you. 

The
nasal areas that you described and would like improved can be addressed with an
artistically performed nasal surgery (rhinoplasty). Yes, the septal cartilage can be used.
Keep
in mind that following the advice from a surgeon on this or any other website
who proposes to tell you exactly what to do and technically how to do it based on  limited  photos without examining you, physically feeling the tissue, assessing
your desired outcome, taking a full medical history, and discussing the pros
and cons of each operative procedure would not be in your best interest. I
would suggest you find a plastic surgeon certified by the American Board of
Plastic Surgery and ideally a member of the American Society for Aesthetic
Plastic Surgery (ASAPS) or facial plastic surgeon that you trust and are
comfortable with. You should discuss your concerns with that surgeon in person.
Robert
Singer, MD  FACS
La
Jolla, California

Dear Elaine, You can refine and rotate your tip without the use of grafts. Removing a small amount of cartilage combined with suture techniques will provide these changes. Seek consultations with experts in the field and have imaging performed to show you the proposed results that can be achieved. Review the surgeons before and after photographs to ensure expertise. Best regards, Michael V. Elam, M.D.