Can this nose be de-rotated/lengthened? (Photo)

Question

I had a septorhinoplasty 5 months ago. My nose was lifted against my wish using septal extension graft. I don't like it's position as it looks too short on my face. I want the tip to be derotated and get the length back Is it possible for me now?

Jeffrey H. Spiegel, MD · Answer

Sure - we can lower the nose back down if desired.  Ironically, a septal extension graft that is longer may be the exact way we do that.  Should be very achievable.

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question. Although an exam in person is ideal, from your photographs alone it does not appear that your nose is too over-rotated. Moreover, there is some de-rotation that can happen in the coming few months, although not much if a septal extension graft was utilized. With that said, however, there are some specific maneuvers that can be performed to de-rotate your nose if it's still too rotated (lifted up) when most of the swelling comes down at 12-18 months. Such maneuvers include utilizing both extended spreader grafts and extended alar contour grafts to bring the tip to length and de-rotate it. Since your own septal cartilage has been harvested, I would use MTF (Musculoskeletal Transplant Foundation) cartilage aka cadaver cartilage to fashion the grafts for your revision surgery if you were to indeed pursue this.

Though you seem to have a good understanding of rhinoplasty mechanics, I would address these technical questions with your rhinoplasty surgeon.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Though you seem to have a good understanding of rhinoplasty mechanics, I would address these technical questions with your rhinoplasty surgeon.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It is possible to perform a tip derotation during a revision. In order to do this, it is necessary to release all scar tissue and place extended spreader grafts to derotate the tip. 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

Best wishes and good luck.

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

Can this nose be de-rotated/lengthened? (Photo)

Answers (3)

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