Short, upturned nose with exposed nostrils

What Defines a Short, Upturned Nose?

Surgeons assess this by measuring the nasolabial angle (the angle between the columella and the upper lip). In Asians, this angle typically ranges from 90 to 100 degrees. When it exceeds this range, the nasal tip rotates upward, making the nose appear short and exposing the nostrils from a frontal view. This is commonly referred to as an "upturned nose," "exposed nostrils," or a "piggy nose."

Common Causes

Congenital: A short nasal septum and lower lateral cartilages, combined with a weak columella, leave the nasal tip without sufficient structural support to project downward. Post-surgical: This is a more concerning category—long-term synthetic implants, infections, or capsular contracture (scar tissue contraction) cause the skin of the nasal tip to gradually retract. Over time, the nose becomes increasingly upturned, sometimes accompanied by redness and skin thinning. This condition is known as a contracted nose and requires prompt medical attention.

Why Is Lengthening a Nose More Challenging Than Heightening It?

Augmentation simply requires placing an implant along the nasal dorsum. Lengthening, however, demands the construction of an entirely new anterior structural framework—typically using autologous septal, ear, or costal (rib) cartilage to create a columellar strut and a septal extension graft—to counter-rotate the nasal tip downward and secure it in place. The primary limiting factor is the skin envelope: the tip skin can only stretch to a certain degree. Over-lengthening leads to excessive skin tension, thinning, graft visibility, or compromised blood circulation (ischemia). Therefore, the surgeon must always balance the desired aesthetic length with the physiological elasticity of the patient's skin.

Realistic Expectations

Congenital short nose with good skin elasticity: Significant lengthening can be achieved in a single procedure, bringing the nasolabial angle into a harmonious range. Post-surgical contracted nose: Due to fibrotic scar tissue, lengthening must be performed incrementally and may sometimes require a two-stage approach. The primary goal is restoring a natural anatomical contour rather than achieving an excessively long nasal tip.

The BonBoz Approach to Short, Upturned Noses

A board-certified plastic surgeon will directly examine your nose, measure the nasolabial angle, assess skin elasticity, evaluate septal integrity, and review your surgical history. For congenital cases, the standard approach is structural rhinoplasty using autologous cartilage for columellar support and septal extension. For contracted noses, the priority is removing old implant materials, thoroughly releasing fibrotic scar tissue, utilizing rib cartilage when necessary, and clearly explaining the possibility of a two-stage procedure. The consulting surgeon is the one who performs your surgery, ensuring all potential risks and recovery timelines are thoroughly discussed before you make your decision.