Do I have an over rotated nose? (photos)

I'm a 28 y/o male and I believe I have an over rotated nose along with a short bridge. It is especially visible from my side angle. I have not had any work done to my nose (this was the nose I was born with). From what I have seen online this situation is rare and complicated to fix. The most common treatment ive seen recommended for this is 'extended spreader grafts.'

Doctor Answers 9

Over rotated nose

If you are concerned that your tip to over upwardly rotated it can be rotated downwards with extended spreader grafts or a caudal septal extension graft - it is the sort of rhinoplasty that only an experienced rhinoplasty surgeon should undertake

Over-Rotated Nose

Thank you for your question and photos.

Tip rotation is defined by the nasolabial angle, which is the angle formed by the upper lip and bottom of the nose.  It is measured on side, or lateral, view only.  The ideal nasolabial angle is 90 degrees in a male and up to 105 degrees in a female.  Your nasolabial angle is approximately 120 degrees, which means you tip is over-rotated.  This goes hand-in-hand with a short nose.  

Lengthening the nose is challenging.  Cartilage grafts to extend the septum and long (or extended) spreader grafts would be required.  Sometimes tip grafts are added to the end of the nose to increase length.  


Raj P. TerKonda, MD, FACS
Beverly Hills Facial Plastic Surgeon

Over rotated nose

The rotation of ones nose is basically the same as nasal length.  If the nose is rotated then it is short, and if it lacks rotation then it is long.  I cannot comment on the rotation of your nose without seeing a side view, also called lateral view, that includes your forehead and chin.  Since this is a concern of yours, I would seek out an experienced Rhinoplasty surgeon who can do this type of evaluation with you and knows the proper grafting techniques for lengthening the nose.  You would surely want to see video imaging on a computer that can give you some idea of the appearance your nose would have with greater length or less rotation.  I hope you find this helpful

Thomas Hubbard, MD, FACS
Virginia Beach Plastic Surgeon
4.9 out of 5 stars 32 reviews

Over Rotated Nose

You do have a short nose, especially for  young man. This can be corrected by lengthening your nose with a cartilage sept extension graft. This is not rare but most often is secondary to a poorly done rhinoplasty. An experienced rhinoplasty specialist is very comfortable with this procedure.

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

Over rotated tip

I'm not sure that I'd describe this as complicated but I think you may reach your goals with tip and caudal columellar extension grafts with cartilage taken from you ears or septum.  You would want a surgeon who provides and clear but detailed plan for you.  Rhinoplasty seems to be approached in two unfortunate ways.  Over-implied or overly complicated.  I think you'd need a carefully planned rhinoplasty surgery that doesn't cut corners. That being said I think your surgery should be fairly straightforward. One thing to be mindful of is that the only foreseeable problem I see for you is the look of alar retraction.  But if done properly that should not be an issue


Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 72 reviews

Rhinoplasty

Hello and thank you for your question. Based on your photograph, you may benefit from caudal septal extension graft.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 reviews

Rhinoplasty question

Thank you for your question.  It appears from your side view, that your nose is overall flatter and shorter. In order to give length to the nose, one option is cartilage spreader grafts to lengthen. In the picture or in consultation, we would also need to see your nose in proportion to the rest of your facial features, including your chin in your eyes.  Only an in person exam and consult would allow us to evaluate everything and discuss the procedures and recovery with you. Good luck! 

Kailash Narasimhan, MD
Sherman Plastic Surgeon
5.0 out of 5 stars 14 reviews

Nasal Rotation

Maverick90,

      It should first be noted that there is no exact "ideal rotation" for a nose, and the nose must be balanced with the rest of the facial proportions.  That being said, for the male nose the typical ideal range is considered to be 90-100 degrees.  From the pictures you provided, your nose may be more rotated than this, but full face photographs and standardized views would be needed to say for sure.  You are correct in noting that this can be a challenging problem to fix.  Extended spreader grafts can help, but may also require a septal extension graft as well.  There are times that the skin and nasal envelope limit the amount of de-rotation that can be accomplished, so best to have a thorough, in-person, exam and consultation.  Good luck.

John Harbison, MD
Omaha Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Rhinoplasty for the short nose.

you do not have an overly rotated nose but rather a short nose. The treatment for this is a septal extension craft along with lower composite  grafts from the ear.  See a very experienced revision rhinoplasty specialist who can show you short noses and their results that he has done. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 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.