Rhinoplasty After Maxillary Advancement? (photo)

Question

My maxilla was moved forward 6mm to open my airway for apnea purposes. Unfortunately, this movement broadened my nose tip and nostril base quite a bit. I have not had any work done on the nose directly. My surgeon suggested the services of an ENT to fix the look of it, but I am skeptical. Would it be posible to narrow the boney base where the nostril inserts at the cheek, or is this done only for the mid-vault? What should I ask in a consultation to get the best array of options?

Stephen Weber MD, FACS · Answer

Your concerns are not uncommon after jaw advancement but hopefully you've benefited from the jaw advancement. Yes, you can benefit from rhinoplasty to narrow the lower portion of your nose. The base of your nose where is attaches to your cheek, can also be narrowed at the same time. I hope this information is helpful.Stephen Weber MD, FACS

Steven J. Pearlman, MD, FACS · Answer

The nose sits on the upper jaw, or maxilla. So any surgery that moves the upper jaw can have a dramatic affect on the shape of your nose. It can also cause a deviated septum since the septum sits in a groove called the maxillary crest of the upper jaw. The nose can be narrowed from top to bottom or selectively. You should seek a qualified rhinoplasty specialist to discuss your goals and desires.

Jose Barrera, MD · Answer

Widening of the alar base is common after maxillomandibular advancement due to the upper jaw advancement and possible buckling of the septum. A rhinoplasty to address the width and buckled septum is appropriate.

William Portuese, MD · Answer

It is fine to undergo rhinoplasty after maxillary advancement surgery, but it is best to wait at least 6 months after the procedure. The goal of rhinoplasty is to narrow the entire nose which is accomplished with both medial and lateral osteotomies. This will narrow both nasal bones and the accompanying upper lateral cartilages. The tip can also be narrowed through different techniques, such as suturing the tip cartilages and conservative cartilage removal. Narrowing the nostrils is best done with an alarplasty procedure whereby a small incision is made at the base of the nostrils, then approximately 3-4 mm of skin is removed, and the nostrils are narrowed.

Richard W. Fleming, MD (retired) · Answer

The nasal changes you have noticed are common after maxillary advancement, which will not interfere with rhinoplasty surgery at this time. The base of your nose and the tip can be narrowed so the nose is proportional to the surrounding facial features.

Rhinoplasty After Maxillary Advancement? (photo)

Answers (7)