If You Shorten a Nose Do You Also Need to Also Extend the Philtrum? (photo)

Hello there, i had a long midface/nose, i was wondering how you actually shorten a nose if the philtrum only reaches the nostril i have included a picture of a women who has the same face type/nose as me to make it easier for you

Doctor Answers 5

A very short nose

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Shortening the nose involves changing the shape of underlying structures. The process involves rotating the tip of the nose up and also elevating the columella. No change will be done to philtrum. Nasal photo imaging can show you what you are after and if its a pleasing result or not.

Sacramento Plastic Surgeon
4.9 out of 5 stars 227 reviews

If You Shorten a Nose Do You Also Need to Also Extend the Philtrum?

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 Shortening the nose is the same thing as rotating the nasal tip upwards.  The proper aesthetics of nasal beauty dictate that the angle of tip rotation be approximately 105 to 115 degrees in women, slightly less in men.  If the nasal tip was rotated to the degree indicated, in the photo, the nostrils would show too much because the  tip would be rotated greater than 120 degrees.  This, IMO would be a very unattractive and un-natural result.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Do I Need To Lengthen My Philtrum When I Shorten My Nose?

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Thank you for your challenging question and also the picture you provided.  The process of shortening a nose is a little bit more of an illusion than a true shortening.  Because the picture you provided shows a philtrum that is crowded by the bottom of the nose (caudal septum), I would elevate the caudal septum approximately 2 mm.  This gives the illusion of a much longer philtrum.  Then, in the distal one third of the caudal septum, I would do a significant upturn of the bottom of the septum.  This elevates the tip of the nose without exposing the nostrils from the front. 

This distal septal elevation, along with the removal of a portion of the superior aspect of the lower lateral cartilage (taking a little bit of the upper part of the tip off), gives the illusion of a shorter nose.  The combination of the above delicate maneuvers uncovers the masked upper lip/philtrum, giving the appearance of a longer philtrum. 

Philtrum and tip

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With tip elevation it may give the illusion of a longer philtrum.  An in office exam is key to evaluate you properly and go over a surgical plan.

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

Shortening the Nose

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When shortening the nose, the base of the nose above the philtrum is not changed or only raised a couple millimeters. The tip in front of your nostrils is elevated (rotated) to shorten the nose; this will not have any effect on your philtrum.

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