Low-nose rhinoplasty and upturned-nose surgery — can septal deviation be corrected together? A case walkthrough
2025. 6. 9.
A case where an upturned nose with a lifted tip and prominent nostrils was corrected through low-nose rhinoplasty, while the septal deviation causing left-right asymmetry was improved together. Explains when rib-cartilage grafting is needed and the design process.
Key points
- An upturned nose is a shape where the lifted tip angle makes the nose look short and the nostrils prominent — balancing the whole nose, not just the tip, matters.
- When the tip angle is lifted a lot, the skin may not stretch enough, so a firm cartilage (rib cartilage) graft may be needed.
- In this case, the tip was lowered and height set with rib cartilage while the septal deviation causing the asymmetry was corrected together — organizing even the nostril shape.
People concerned about an upturned nose usually have a considerably lifted tip and prominent nostrils. A tip angle lifted upward can also make the nose look short, so in low-nose rhinoplasty balancing the whole nose — rather than touching only the tip — matters greatly.
This article organizes the process of an actual case where an upturned nose was corrected while septal deviation was improved together.
01
Why can firm cartilage be needed in upturned-nose surgery?
The core of this surgery was correcting the upturned nose. When the tip angle is lifted too far, the skin may not stretch enough, so a firm cartilage graft may be needed — because lowering a lifted tip requires a structure that can hold that position.
So in this case the tip was lowered with rib cartilage while the height was set together. The elements checked in tip correction can be seen in more detail in the nasal-tip procedure guide.
02
Why was septal deviation corrected together?
This patient had left-right asymmetry, and septal deviation was among its causes. Because the asymmetry would remain if only the tip were lowered, the septal deviation was corrected together with the upturned-nose correction.
As the septal deviation was corrected together, the nostril shape was also organized, bringing the nose closer to the shape the patient wanted. The surgical composition can be organized as follows.
| Confirmed state | Correction performed |
|---|---|
| Upturned nose with the tip angle lifted upward, prominent nostrils | Lowered the tip with rib cartilage while securing height |
| Left-right asymmetry (septal deviation) | Septal-deviation correction — leading to organized nostril shape |
| Step-off around the bridge | Raised the tip with rib cartilage, filled the step-off, and used an implant (silicone) |
Compared with before surgery, the area around the mouth appears to settle inward while the nose's dimensionality revives — changing to a more masculine impression, with the added effect of the mouth looking less protrusive. The before-and-after can be checked in before-and-after photos.
03
What does pre-surgical design look at?
Because upturned-nose surgery changes the tip angle, the design stage — deciding how far to lower and how much to raise — matters. What is checked in this process is as follows.
- CT — the patient's CT is referenced to check the nose's internal structure.
- Pre-surgical photos and the desired image — direction is aligned while viewing the pre-surgery photos and the ideal nose photo the patient wants together.
- Overall balance — the whole face's balance is analyzed for design, including the forehead and chin bone structure and skin thickness.
04
Summary — the tip angle and asymmetry must be viewed together
An upturned nose is a problem where the lifted tip makes the nose look short and the nostrils prominent — but correction doesn't end with the tip angle alone. Depending on how far the skin can stretch, a firm cartilage graft may be needed; and if septal deviation is the cause of asymmetry as in this case, it must be corrected together for even the nostril shape to be organized. That is why design looks at CT and the whole face's balance.
If you're curious what structure your nose's lift and asymmetry come from, you can be checked directly in a 1:1 video-call consultation.
Frequently asked questions
Answers to common questions patients ask before a consultation.
Is an upturned nose solved just by lowering the tip?
Why is rib cartilage used for upturned-nose surgery?
Does upturned-nose surgery change the impression too?
Responses to treatment and recovery progress vary by individual. Outcomes and side effects vary from person to person. Bleeding, infection, swelling and asymmetry may occur. Please consult our medical team before making a decision.