How is Tip Cartilage Rotated?

Can tip cartilage rotation be reversed?

Doctor Answers 10

How is the nose rotated by surgery?

This is a technical question really and one that is commonly asked during specialist examinations. The theory is the following; imagine the tip of your nose the seat of a three legged stool. One leg is the flesh between your nostrils and the other two run along the rims of your nostrils, up towards the outer corners of your eyes. If you wanted to till the seat back, then two of the legs need to be shortened, or one lengthened. Surgeons have many, many different techniques to do this to the cartilages which make up the tip of your nose.

Toronto Facial Plastic Surgeon
5.0 out of 5 stars 89 reviews

Nose Tip Can Be Turned Up or Down

Rhinoplasty (nose surgery) can refine your tip to make it smaller, as well as change its position.  Changing the position of the nasal tip in an upward manner is called "rotation", while turning the nose downward is referred to as "de-rotation". Your question asks if a surgically rotated nose can be de-rotated, and the answer is yes.  A revision rhinoplasty would be necessary, as well as a cartilage source (septum, ear, or rib) to bring your tip back down.  If your surgery was recently, you'll want to discuss your concern with your surgeon, but you might not be a candidate for revision until your nose stops healing (about 1 year). And I always recommend using digital imaging software to have your surgeon show you what you might look like after the surgery so the 2 of you can communicate effectively regarding what you think looks best. Good luck!  

Randolph Capone, MD, FACS
Baltimore Facial Plastic Surgeon
4.7 out of 5 stars 51 reviews

Nasal Tip Rotation

There are several techniques to decrease tip rotation after rhinoplasty surgery. For example, sometimes the tip can be repositioned and simply sutured in place but frequently it is necessary to add cartilage grafts. See a revision specialist because the procedure is always individualized to meet the needs of each patient.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Can tip rotation be reversed

There are definitely techniques to achieve tip derogation if needed. The can be done with repositioning and changes to the caudal nasal septum. It depends on what is needed for an individual situation.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Tip rotation can be reversed

Tip rotation can be reversed, or derotated.  Assuming you mean the original rotation was increased, counter rotation will require revision surgery.  As rhinplasty is one of the most challenging surgeries to perform well, this can be difficult depending on what was done originally.  However, there are various techniques available to a facial plastic surgeon that can achieve the desired results.  Hope this helps.

Kenneth Yu, MD
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Tip cartilage rotation

Can tip cartilage be reversed?  It is very difficult to return the cartilages to the way that they were.  Often sutures are placed in to them and then scar tissue keeps the shape.  Other cartilage grafts may be necessary to recreate it.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Reversing tip rotation

There are book chapters which discuss methods to rotate the nasal tip, and just how much, and upward rotation is fairly easy to achieve. Reversing tip rotation can involve tip grafts, and nasal lenghtening, again book chapters, and though a more difficult problem, there are solutions experienced surgeons know about.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Rhinoplasty revision

There are probably as many ways to rotate the tip cartilage as there are surgeons to do it. Some of those ways include trimming the upper edge of the tip cartilages, suturing the tip cartilages to the septal cartilage, placing a batton graft between the septal cartilage and the inner limbs of the tip cartilages etc. You can reverse the direction of tip rotation from a previous surgery but depending on the circumstances you may not be able to get complete reversal.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

Tip Rotation


There are several techniques for tip rotation. They include but not limited to dome division, cephalic strip, strut grafts, shield grafts and reduction of dorsal septal cartilage. Again it all depends on the tip dynamics preoperatively.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 reviews

Techniques to rotate and counter-rotate the tip in rhinoplasty

A variety of techniques exist to rotate the tip cartilage, including suturing, cartilage reshaping, and grafting techniques.  I won't get into the technical details here.  There are also several techniques to counter-rotate the tip including septal extension grafts and extended spreader grafts.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 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.