Can nasal tip projection and elevation be negotiated endonasally?

I have a very unevenly projected nose (septal graft in assymetric tip) the right side of my tip has little or no projection, and the left is derotated, but well-projected. I care because in revision, I would like to create symmetry in the tip, obtain moderate projection to narrow, and then elevate my nose about 1 mm to bring out my eyes and my top lip and so I can smile without my nose dipping. Is this an achieve goal? Currently, I have a similar problem as this woman.

Doctor Answers 3

Endonasal rhinoplasty

 Endonasal rhinoplasty can accomplish the goals of making the tip more symmetric with  suture techniques applied to the lower lateral cartilages. Advanced cartilage grafting techniques can also be applied to give more projection to the tip. Endonasal rhinoplasty can also lift the tip. For many examples, please see the link  below to our endonasal rhinoplasty photo gallery


Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Can nasal tip projection and elevation be negotiated endonasally?

Excellent cosmetic results can be achieved in initial rhinoplasties as well as in revisions with both techniques, closed (endonasal) or open. There is not a best way to perform the procedure. Individual surgeons have their own preferences of how to produce the best results in their hands. What is more important than whether a closed or open approach is utilized is the experience and artistry of the plastic surgeon and your comfort level and confidence in that individual.

Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California



Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Revision rhinoplasty

I prefer to perform revision rhinoplasty most of the time using an open technique.  You would have to be seen in person to determine what the issues are.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.