Correction of Upturned Nose Tip After Rhinoplasty?

I had a Rhinoplasty and the tip is slightly upturned. Is there a way to down turn it so the nose projects more? If it's turned down, how many mm will the nose project?

Doctor Answers 8

What to do with an upturned tip after rhinoplasty

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The first thing I'd want to know is how long it has been since your rhinoplasty. If early (3 months or less), it is possible that the tip rotates even more as healing occurs, or conversly (depending on how the rhinoplasty was performed) that the tip settles back down into a more normal position. A lot can happen in the first year after surgery, which is why it is important to wait.

If after 1 year the tip is still in an undesirable position, have your nose re-evaluated and discuss the possibilities with your surgeon. If your nose is still over-rotated (upturned), there are techniques to de-rotate the nose. Understand, however, that turning an upturned nose down is one of the more difficult changes to achieve in a revision rhinoplasty procedure. It is not simple and requires a skilled rhinoplasty surgeon. Good luck.

Baltimore Facial Plastic Surgeon
4.7 out of 5 stars 51 reviews

Upturned nose can be turned downward to some degree

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An upturned nose can be turned downward to some degree with multiple different tip techniques and structural cartilage grafting. It is difficult to make the nose project more by turning it down. Usually when bringing the tip downwards you also decrease the projection. Conversely, when trying to increase projection, the tip usually goes up. The nose can project or de-project no more than about 3 to 4 mm with the two procedures available.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Short Nose

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The nose can be "de-rotated" after rhinoplasty. You do not mention when the surgery was done. Swelling, which can give the appearance of increased rotation, may last 9-12 months. Lengthening the nose and increasing projection are frequently done by experienced surgeons.   

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty tip revision

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Yes, the tip of the nose may be able to be brought down a bit in a revision rhinoplasty. Usually I wait at least 1 year to perform revision. 

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revision Rhinoplasty

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Correcting an over-rotated tip after previous rhinoplasty can be challenging.

The nasal tip position is determined by an interplay between the strength of your tip cartilages and the supporting structures around it; the most important of which is the nasal septum. If this structure was trimmed back at the time of your first operation, then the correction becomes more difficult. If grafting or suture remodeling of the tip was done at the time of the first operation, then those maneuvers may have to be reversed or refined in order to drop your tip down.

So you can see, there are many different ways to correct this problem. It depends entirely on what was done in the first operation. Make sure to try and find a surgeon that specializes in nasal surgery. That will be your best chance of second time success.

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 55 reviews

De-rotating the tip

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 The answer is yes.  Tip de-rotation is possible, however the techniques used are advanced and require an experienced rhinoplasty surgeon.  The outcomes can be excellent.  Good luck. 

Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Rhinoplasty Revision of Upturned Nasal Tip

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Hi Zaddy,

Yes, a nose that is slightly turned up at the tip can be revised to increase the projection.  It is an advanced technique in rhinoplasty so make sure that your rhinoplasty surgeon is comfortable with the procedure.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Yes it is possible.

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 We can derotate the nose and project it as much as we wish. But this requires a great deal of experience. You should see an experienced revision rhinoplasty surgeon. You can go to our website to see examples of derotated revision noses.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 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.