Aesthetic issues with the nose are never pleasant to deal with, especially with the nose’s prominent location on the face and the effect it has on overall facial balance. There are many reasons why someone might choose to pursue cosmetic nasal surgery (rhinoplasty), and the procedure is an extremely versatile and custom procedure that can improve anything from a nasal hump to a crooked nose, to a nose that is too large or too small. One of the most difficult and complex problems a surgeon can face may seem a bit surprising: the upturned, or over-rotated nose.
The Over-Rotated Nose
The over-rotated nose describes a nose that turns up too far at the tip, and is generally overly short as well. This issue can cause almost a “pig nose” effect, as the nostrils in an upturned nose are overly prominent.
An over-rotated or upturned nose can be caused by a number of factors, including genetic nasal structure or complications from a former rhinoplasty. When the problem is a result of a previous surgery, this typically means the nose was resected aggressively, and too much tissue was removed.
Rhinoplasty Techniques for Over-Rotation
An already difficult procedure, most surgeons agree that addressing an overly-rotated nose is no easy task. As with most rhinoplasty procedures, the process relies heavily on cartilage grafts, typically taken from the nasal septum, ear, or rib. The grafts are used to build up over-resected areas of the nose, add structure to the tip, and pull down the nasal tip to make the nostrils less prominent. Most surgeons prefer the “open” rhinoplasty technique these days, which involves an external incision between the nostrils, but gives surgeons good visibility while performing the procedure.
Whether the procedure is primary rhinoplasty or a revision surgery, the principle techniques are the same. The major difference is that revision rhinoplasty is even more difficult than primary procedures, since there is more scar tissue and weakened nasal structures. Despite this, a skilled rhinoplasty surgeon can typically make great improvement even in difficult revision procedures.
As with any plastic surgery procedure, it is important for patients to keep their expectations in check and be aware of what is realistic. Expecting perfection will only lead to disappointment, and prospective patients would do better to aim for marked improvement over perfection. Rhinoplasty can accomplish some amazing goals, but it cannot work miracles.
Choosing a Surgeon
With such a difficult procedure as repairing an over-rotated or over-shortened nose, choosing a top plastic surgeon is key to a beautiful result that will last a lifetime. A good plastic surgeon has skill, knowledge, compassion, artistry, and the ability to predict outcomes. Versatility is important for a rhinoplasty surgeon, as every person is different, and rhinoplasty relies heavily on customization to achieve facial balance.
When choosing a surgeon, be sure to seek out candidates who are board certified, experience, and focus much of their time on the art of rhinoplasty. There are many excellent surgeons out there, but the number that has true expertise in nasal surgery is fairly small. If you would like to discuss your goals with a surgeon who has over 25 years of experience in rhinoplasty procedures, contact Bentkover Facial Plastic Surgery in Worcester (508-363-6500), or Stoneham (617-247-0033), MA to set up a consultation with acclaimed facial plastic surgeon Dr. Stuart Bentkover. Dr. Bentkover has experience in helping a diverse patient base reach their rhinoplasty goals, and is standing by to help you reach yours.