Do I Have an Over-Rotated Nose?

My nose appears to be over-rotated. I'm getting different opinions however from doctors.The tip,when slightly forced down closer to my lip makes it appear much more natural.the sides have messed up cartilage,appearing really wide and uneven,and need fixing as much as the tip also.I am desperate to get this fixed and will do anything to relieve the anxiety I've felt all my life because of it.I am extremely shy and anti-social as a result of this.

Doctor Answers 12

Over-rotated tip- A problem or Illusion

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Your photos tell a more intrigueing story than the history given. The photos reveal someone who has significant nasoethmoid trauma with loss of dorsal support, epicanthal folds, asymetric orbital rims and mild ocular dystopia. It also appears that an attempt has been made to graft the dorsum but the grart was inadequate to achieve the necessary dorsal projection and support. The nostrils are asymmetric indicating possible previous intranasal incisions. The tip is the least significant of your problems as addressing the tip only will not improve the aesthetics or function of your nose. These are complex problems requiring a surgeon with experience and the ability to obtain autologous graft material from sources other than the nasal septum.

Hoover Plastic Surgeon

More than one issue here?

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Your tip may have the illusion of being over rotated as a result of the curve of the bridge. If you were to undergo further surgery, augmenting the bridge with rib (either your own or cadaver) may improve this. One way to see what the effect would be is to have a consultation with an experienced revision rhinoplasty who can perform photo morphing for you to show you the effect of building up the bridge and/or changing rotation. It is important before further surgery though that you find a comfortable and confidential source with whom to discuss the anxiety. Conquering this before undergoing further surgery will set you up for success :)

Jeffrey Watson, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Over-Rotated Nose

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If you're not receiving psychological care, it is very important for you to consult with a psychiatrist or psychologst to evaluate your surgical  motivations and expectations. Your nose can be de-rotated, projection decreased, and tip contour improved.

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

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It does not appear that your nasal tip is over-rotated. It actually looks okay.  Preo-operative photographs would be helpful to compare to.

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

Over-rotated nose tip?

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You don't specify if you have had prior nose surgery or if this is a result of injury. But in either case, your nose tip is NOT over-rotated, you have a saddle nose deformity, or collapse of the upper two-thirds of the nose. This is usually a result of injury, but can also be a result of surgical over-resection of the nasal dorsum. Your nasal tip does not project excessively, and your nasolabial angle is normal, further evidence that the nasal "defect" is not over-projection OR over-rotation of the nasal tip, but lack of sufficient tissue from the too-low radix to the normal supratip "break."

The proper surgical  correction involves graft to the nasal dorsum to augment the area of deficiency, NOT removal of nasal tip cartilage. The lateral crural of the alar cartilages may need reconfiguration via scoring or other techniques to improve symmetry of the nostril rims and base. I would not recommend Weir excisions initially, as these can be added later under local anesthesia if necessary or desirable.

However, I would not recommend any nasal surgery for someone who feels their nose "causes" anxiety, shyness, or antisocial behavior. Even if your nose is absolutely perfect, that will not change the person you are, nor will it make you less shy or more outgoing. Nose surgery changes only the nose, and you have to stop using your nose as the "excuse" for your lack of social skills, because when your nose is changed surgically and your social skills remain the same as they always have been, you will again blame your nose (or, more accurately, your nose surgeon) for your own shortcomings. Please take heed to this as your nose doesn't smile, say "Hello" with a gleam in your eyes, or speak kindly, thoughtfully, and compassionately to those around you. Your nose isn't helpful, a friend in need, interesting to talk to, or enthusiastic. Your nose just sits on your face and smells and breathes, nothing more, Think about Barbra Streisand, Tom Cruise, or Owen Wilson. If noses held people back, they would be nobodies! Good Luck and Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Overly rotated nose tip (PHOTOS)

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This is not unlike the appearance of a Boxer's nose or Saddle nose. The dorsum, if augmented, would make the tip appear less rotated. Numerous options for facial improvment are available and could be considered after a thorough evaluation of the external and internal structures of your nose are completed. Discuss this with a qualified surgeon.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Do I Have an Over-Rotated Nose?

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The simple answer is yes to "over rotated" but in medical terms you have more of a deviation/collapse. Best to see a very experience rhinoplasty surgeon in your area. From MIAMI Dr. Darryl j. Blinski

Your nose is not over rotated

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Hi tmj,

Your nose is not over rotated.  The rotation of your tip (the angle between your upper lip and the bottom of your nose) appears normal.  However, your nose does appear to be over projected (it sticks out too far from the face). This is made worse by a loss of height of your nasal dorsum and it appears that you have had surgery before, which makes your surgery more complicated.  Rhinoplasty performed by an experienced nasal surgeon can be helpful; however, I caution you that the shyness, anxiety, and antisocial tendencies will not likely be improved through rhinoplasty.  I believe that you would benefit from an evaluation by a psychiatrist to help with your social concerns.

Good luck!

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 50 reviews

Over-rotated nose

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It does appear from the pictures you have provided that your nose appears over-rotated. It is too short for your face and needs to be de-rotated and brought closer toward your face. Most likely if you have not had previous surgery before, you can use cartilage from inside your nose to lengthen it and correct irregular areas of your tip as well. I hope this inofrmation helps

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Over-Projected and Boxy Tip

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I would say that your tip is over-projected. You also have wide boxy tip cartilages. The bridge of your nose does not flow with the tip of your nose. I believe if you raise your bridge and reconstruct your tip cartilages, you can achieve more harmony in the way your nose looks. I also believe it will improve your self-esteem and overall outlook. There are studies that prove that.
Best of Luck,

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 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.