How to correct the upturned nose?

Short nose or upturned nose correction is often considered as the most difficult kind of rhinoplasty. When we talk about this procedure, in majority of cases we talk about revision surgery. Short nose or upturned nose is mostly a result of failed or multiple surgeries or post-operation infection. Only the small part of surgeries are primary operations.

What makes short nose correction so complicated is firstly, the fact that most of them are revision procedures and secondly the character of the deformation itself. When performing this operation, the surgeon must consider two conditions for successful and satisfying operation: the nose must be made longer and at the same time visible nostrils must be corrected. To achieve satisfying result the surgeon must have a lot of experience, preferably in revision rhinoplasty and extraordinary skills.

Techniques of short nose correction

The technique of short nose correction is chosen concerning the seriousness of the case. If the nose is just slightly short and nostrils are not overexposed the operation with usage of ear or septal cartilage to make the tip longer. Such case often occurs for naturally short nose, so it is not necessarily a revision surgery.

A case of mildly upturned nose and correction result

If the nose is seriously short and upturned, the surgeon must perform a much more complicated operation. There are couple of ways surgeons use in such cases.

Seriously upturned nose and the result of correction

Basic technique of the release is repositioning and fixation of lower lateral cartilages (LLCs).

Lower lateral cartilage should be released from the scroll area, hinge complex and membranous septum. To maintain and fix the released LLCs, one of the following techniques can be applied: septal extension graft, derotation graft.

Septal extension graft (1) is the most preferred and the most frequently performed technique for the short nose.

Derotation graft (2) is another technique for the fixation of lengthened LLCs. This technique uses the ear cartilage for the fixation of the LLCs. Camparing to septal cartilage graft this technique gives softer and more movable tip.

The third technique is hybrid cartilage graft (3). This technique is used when the patient has extremely small amount of septal cartilage and hybrid of septal cartilage, ear cartilage and rib cartilage must be used.

Dr. Suh Man Koon expertise in short nose correction surgery.

Dr. Suh Man Koon – JW Plastic Surgery director and rhinoplasty specialist is known for his expertise in short nose surgery and revision rhinoplasty. He published many articles about revision short nose correction and revision rhinoplasty in top academic journals, such as Annals of Plastic Surgery, The Journal of Cranofacial Surgery, Aesthetic Plastic Surgery and many more.

Recently Dr. Suh’s proficiency in short nose correction has been recognized by ISAPS (International Society of Aesthetic Plastic Surgery). Dr. Suh will present and discuss Tips & Tricks for Secondary Short Nose Correction during ISAPS Virtual Olympiad on September 5th this year. He will present there as one of the Top 50 Experts from 5 continents.

We have published a hint to Dr. Suh’s presentation before: LINK