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

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

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.

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.

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

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!

We'd need to lengthen your nose. This can be done with a donor rib graft which we keep in our office, or, with your own rib graft. We can then lengthen the nose so it is less rotated. Should take about 90 minutes.

YES, of course "over-rotation," excessive tip elevation, foreshortened nose, low radix, excessive nostril show, tip definition, and almost any and all disappointments with nasal appearance can be improved and/or completely resolved. Establishing partnership with skilled surgeon and communicating your preferred appearance relative to current features is the first step. Patients' understanding the surgical plan and how it will accomplish the desired result is also (I believe) important, so if problems do arise, you understand why and participate in the solution.

Lengthening a nose as short as yours is a very challenging problem. You could get some improvement but make sure your surgeon is highly experienced dealing with your specific problem.. I do a lot of rhinoplasties and I could not take on your case.

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include placement of extended spreader grafts to help derotate your nose, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hi,thank you for questionYour Nose seems to have overrotated Nose tip,retracted alar cartilages,it looks ilke operated Nose.It can be fixed by lenghtening the short Nose Septum and supporting the alar cartilages by grafting.ıt brings your Nose appearence to more balanced situation in your face harmony.Best Regards
Emin Eren,MD