In the first 2 months post op the nose looked great but then the tip started to downturn. When I smile it looks terrible and even when I don't the tip is somewhat droopy. I've talked to my doctor in the meantime and he said he'd do the revision free of charge after 6 months (which is happening next week). He told me he'll remove this tiny bump on the 2nd third of the nose. Will that be enough? I heard it is also possible to cut small muscles in the tip so that it doesn't go down? Thank you.
Revision to Correct Droopy Tip - Best Technique?
Doctor Answers (5)
Correction of "Droopy" Tip
Several changes should be considered. The columella should be elevated, and strengthened with a cartilage graft if necessary. Tip projection should be increased by advancing it forward with the columellar repositioning. A cartilage tip graft will probably be necessary. The fullness above the tip can be reduced by the removal of scar tissue or excess cartilage. Cuttting the depressor septi muscle wiil minimally decrease "droopng" of the tip when smiling.
That is great news that your surgeon will do the revision for you. Since he knows what was done the first time, it will make it easier to adjust it this time. It sounds like you need a tip graft or better tip support with sutures. Cutting the muscles may or may not help.
Revision for Droopy Tip
I would consider an open rhinoplasty and a cartilage shield graft to elevate and project the tip. Cutting the nasal depressor muscles may improve the drooping a little but not to the extent that you need.
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Revision of nasal tip
As others have stated, in order to improve the droop and the fullness above the tip you need better tip support with a strong columellar strut graft.
You will require tip support with a columella-strut for a successful Revision Rhinoplasty.
I read your concern and reviewed your profile photo. In my view, the problem is more due to lack of tip support than due to the bump. The bump above your tip may need to be shaved down, but your tip needs support and projection. This may be obtained by placing a strong columella strut in a pocket between your medial crurae. The C-strut may be harvested from your nasal septal cartilage if it's still available.
I hope this is helpful for you.
Regards from NJ:
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