Can this degree of over rotation be corrected? (Photos)

Question

I’ve genuinely disliked my nose since I was old enough to form my own opinion (so since the age of around 4). I was bullied throughout my school years because of it, and - 60 next year - still dislike it. No amount of contouring improves it,. It’s just a small, bulbous, caricature like annoyance. All I see in the mirror and on photos are nostrils! Can this degree of over rotation be corrected or improved in any way? I dream of a straight, chiselled nose (I’d be thrilled with a nose like Catherine, Princess of Wales), but realistically less nostril on show would be heavenly! Any advice would be so gratefully received. Thank you.

Eric M. Joseph, MD · Answer

I do believe that successful revision surgery is possible, however, the expertise of your surgeon would be paramount. You would likely require a septal extension graft, and extended spreader grafts, to lower the tip of your nose, and to create a longer nasal appearance. Please consider meeting with several reputable rhinoplasty specialists who have performed similar operations, so you could see what to expect moving forward.

Additionally, I believe you do have a permanent non-surgical approach, if you desire, that would be aimed at lowering your nostril margins on front view for less nostril show, and improved nostril symmetry. Depending on your examination, microdroplet Silikon-1000 nasal injections may be considered for lowering your nostril margins, decreasing nostril show, and for achieving several millimeters of nasal tip derotation. I hope this helps! Sincerely, Dr Joseph

Gary M. Horndeski, MD · Answer

The nasal columella angle is over 110 degrees, which is beyond what is desirable for a woman.  This will be corrected by using septal extension grafts and can be harvested by using your own septum or cadaver donor.  This is done on both sides of the septum, will lengthen the nose and correct the over rotation.  This will take 2 hours to perform under general anesthesia and costs $8,000.

Best Wishes,

Gary Horndeski, M.D.

Andrew Miller, MD · Answer

A nose that has been upturned during rhinoplasty has a better chance of being derotated. If this is your natural nose without any surgery it can be harder because your skin envelope is small. That being said, there are some things to do to lengthen your nose and derotate it some. It may not be chiseled in the end, but should have less nostril show. Be sure to see a rhinoplasty expert for consultation.

Ramin Behmand, MD, FACS · Answer

Thank you for sharing your story. From the photos, your nose and skin quality appear to be in excellent condition, and I do believe there are options to improve the over-rotation you’re experiencing.

When a nose appears short with excessive nostril show, one consideration is whether the skin will allow for safe and natural lengthening. Based on your photos, this seems very possible in your case.

There are a couple of surgical techniques that could help achieve your goals. One option involves using extended spreader grafts to lengthen the nose and reduce nostril show. Another is the tongue-in-groove technique, which offers more structural support and control by stabilizing the tip position—often using a cartilage graft in the columella for added projection and support.

Both can be tailored to help move you toward a more refined and balanced profile, and I believe you could see a meaningful improvement. Be sure to find an experienced rhinoplasty surgeon.

Dr. B

Zeshaan Maan, MD · Answer

Hi,
It is certainly possible to improve your tip position and nostril show with surgical rhinoplasty. The key maneuver to correct the rotation would involve a caudal septal extension graft. Depending on the amount of change you want and the availability of septal cartilage, you may possibly need cartilage from somewhere other than the nose. Your best bet is to have a consultation with a plastic surgeon focused on rhinoplasty!

Can this degree of over rotation be corrected? (Photos)

Answers (10)

Answer: Can Over-Rotation of the Nose Be Corrected at My Age?

Answer: Can Over-Rotation of the Nose Be Corrected at My Age?

Answer: CSE graft

Answer: CSE graft

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Can this degree of over rotation be corrected? (Photos)

Answers (10)

Answer: Can Over-Rotation of the Nose Be Corrected at My Age?

Answer: Can Over-Rotation of the Nose Be Corrected at My Age?

Answer: CSE graft

Answer: CSE graft

Browse related questions

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.