Impactions and/or forward movement of the upper jaw is the biggest factor in the nose widening and upturn. I got a cinch and a v-y closure and still saw significant widening and a little upturn after my first surgery. But my upper jaw was also over advanced in that surgery too. It was brought back for revision and another cinch done and I feel like it's better now, but still much wider than what I started with pre op. Unfortunately it's kind of the cost of doing business if you want to get your bite right and need the fwd/up movements on the top jaw. For me it's a fair price to pay to make it all functional for the bite, but it may not be for you. Part of the risk vs. reward you have to weigh.