Rhinoplasty After Maxillary Advancement? (photo)

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?

Doctor Answers 7

Rhinoplasty After Maxillary Advancement?

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

Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Nasal widening after maxillary surgery

Widening of the nasal base is common with maxillary advancement.  I generally place a permanent "cinch" suture through the  maxillary surgical site to help decrease this.  You could still have this done through the oral incision or may need alar base reduction as part of a formal rhinoplasty.  Donald R. Nunn  MD, DDS  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 47 reviews

It is very common to have changes in the nose after upper jaw (maxillary surgery), these can be improved

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.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 125 reviews

Nasal Changes after Mid-face Advancement

There are various surgical maneuvers that will change the shape and dimensions of the nose.
To narrow the base of the nose, the pyriform aperture, or the bony opening of your nose is not narrowed. The base is narrowed by a procedure called Weir excisions. This will result in scars along the insertion points of your nostrils and cheeks. Sometimes incisions just inside the nasal sill can be made to narrow the base, as well. A closer, more detailed examination of your nose will help to determine if this is possible.
An evaluation by an experienced rhinoplasty surgeon will be the best way to achieve your goals.
Thank you for your question and photos. Best of Luck!

Gregory C. Park, M.D.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 164 reviews

Nasal widening after maxillomandibular advancement

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. 

Jose E. Barrera, MD, FACS
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 46 reviews

Rhinoplasty after maxillary advancement

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.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty after Upper Jaw Advancement

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.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 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.