Revision Rhinoplasty to Shorten a Long Nose?

A long nose is often the result of a droopy tip, so elevating the tip will make the nose look shorter.  This is best accomplished under general anesthesia so that the tip can be properly fixated to the septum or a cartilage graft.  A properly fixated tip will not change position over time.

There are several methods that could be used to shorten the appearance of a long nose based upon your particular anatomy. Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

you ask some great questions.  the answers depend on the nature of the issue and photos would be helpful.  that aside lets see if this helps.  a long nose can be shorted by reducing the caudal septum (that is one way, there are others),  this can be done under local if that is all that is needed,  the swelling would likely be much less than a full rhino and recovery could be quite brisk.

Dear July1990

Thanks for your questions. In my revision practice, this is a common issue.  In all cases the solution is individualized based upon your specific anatomy.  Namely, what is the status of your septum.  Contrary to popular belief, shortening the caudal septum does not guarantee shortening of the nose.  In some cases, all that happens is the tip drops and the nose may actually look longer!  On the other hand, the technique can work if combined with other methods to support the nasal tip.  The septum may not need to be shortened at all.  A number of other possibilities exist, and would be impossible to determine for you (even with photos) without a good exam by an experienced revision rhinoplasty specialist.

With regards to the anesthetic to be used, I would say that few revision surgeries are truly minor, and this may not be.  A local anesthetic may limit the number of maneuvers your surgeon can use, but maybe h/she has experience with doing this. 

At 14 months, most of what is left is scar tissue, but we know that even this can change over time. 

I hope this helps you and good luck!

Dr. Most

Thank you for your question.  The most common procedure to shorten the long nose is to rotate and elevate the nasal tip upward which makes the tip of the nose closer to the face and makes the long nose appear shorter.

Resection of the caudal nasal septum can also be helpful.

However it is very important to prevent dropping or downward rotation of the nasal tip following revision rhinoplasty.  This is accomplished by placing a strut cartilage graft between the medial crura of the cartilages beneath the columella that is the skin separating her nostrils.  The cartilage graft and columella can then be sutured to the caudal edge of the septum rotating the tip upward.  Without a strut graft there is risk that the tip will drop again and create a longer nose appearance.