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Rhinoplasty to Imrove Droopy Tip but Have Concerns How Tip Rotation Will Look on my Face (photo)

asked 7 months ago by casablanca in new york
Latest answer by William Portuese, MD
Question viewed 383 times
Tags: droopy, long, nose tip rotation, opinion

Hi, My nose droops significantly when I smile and also loses it's shape. I want to fix that as well as refine the tip and slightly rotate it up as I get older it looks longer. However, I have a long face and I am afraid that it will look worse from the front if the tip rotation shortens the nose. Do you think a small tip rotation and tip narrowing can be achieved without optical shortening the nose? Any advice on how exactly the shape can be improved?

18 answers to Rhinoplasty to Imrove Droopy Tip but Have Concerns How Tip Rotation Will Look on my Face (photo)

Rhinoplasty for the short nose.

You appear to be short enough, but you need increase in the projection of your nose. I would need to see better photos . Make sure you see an experienced rhinoplasty surgeon for the best result.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Rhinoplasty to Improve Droopy Tip-How will Tip Rotation Look on My Face

It appears from this photograph that your head is slightly tilted to the right in the photograph in repose. When your face is animated you have an over active muscle that isdefinitely pulling the nasal tip down. You would benefit from nasal cartilage refinement, but it must not be overdone. It appears your skin is thick and if too much cartilage is removed you may experience alar valve collapse and have difficulty breathing after surgery. Your nose should not... more

Rondi Kathleen Walker, MD
Washington Plastic Surgeon

Computer imaging is a great way to show how your nose could look after surgery

Patients are sometimes afraid to have rhinoplasty, fearing that changing their nose will alter their face or might not look good on their face. An experienced rhinoplasty surgeon can disuss all these possibilites as well as what might work with the way you look, also taking into account your ethnic identity. I really like computer imaging for these reasons. Imaging helps the discussion about goals and how rhinoplasty can improve your nose but still not make you look too different... more

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

Rhinoplasty to improve droopy nose tip

The drooping of the tip upon animation occurs because of the depressor septi ligament. This ligament is released at the time of surgery to prevent the nose from drooping down upon smiling. Nasal tip refinement can be incurred through multiple different techniques including removal of a small amount of cartilage from the nasal tip as well as tip suturing techniques to narrow and refine the nose. There usually is a slight upward rotation to the tip at this time upon... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Tip Drooping can be an illusion

Sometimes the tip looks like it is drooping, but in fact, it only appears so. The position of the tip is related to the "alae" which is the piece of skin that forms the outside of the nostril. Sometimes the point where the alae meets the facial skin is what rises when you smile and gives an illusion that the tip is falling! So, it is important to get the right assessment as to what is occurring in you before any recommendations are made. more

Philip Miller, MD
New York Facial Plastic Surgeon

www.drphilipmiller.com

It can be done

Casablanca, Nasal surgery has become very refined in the current day. The subtle tip rotation and refinement that you seek can be performed without changing the length of your nose. The droopiness with smiling can be addressed by cutting or removing a small muscle at the base of the nose that causes this phenomenon. Also, from the photos it does not appear that you have a long face. Consultation with a board certified plastic surgeon will better define your goals,... more

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Modifying a droopy nasal tip with rhinoplasty surgery can be tricky.

It is very difficult to give you advice with these photos, however it is clear that your muscles that pull your tip down are extremely active when you smile. This step to surgically interrupt these muscles is just one step in the procedure that will need to be discussed when you have your in depth consultation for rhinoplasty surgery. Good Luck

Laurie Casas, MD
Chicago Plastic Surgeon

Shortening your nose

Although your photos give limited information about the appearance elf your nose, it doe appear that some raising of the tip would be beneficial. There are a number of surgical techniques used to accomplish this but it is generally pretty straight forward. You should consult a plastic surgeon with extensive experience with rhinoplasty to get their input and advice. Good luck.

Ronald J. Edelson, MD
San Diego Plastic Surgeon

Rhinoplasty and Tip Rotation

Your nose is best evaluated when you are not animated. Having said that , a muscle at the base of your nose can be cut to decrease the drooping of your tip when you smile. Your tip can be narrowed and defined while increasing tip projection. While slight tip rotation is appropriate, it also appears that you have a hanging columella which contributes to that droopy tip look. Rhinoplasty surgery is a combination of multiple subtle maneuvers.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Rhinoplasty

Your photos show your nasal tip is rotate clockwise on the front view and the tip gets pulled in towards the plane of the face on smiling. These limited photos do not allow full assessment and the rotation on frontal view may even be due to your turning your head slightly in the photo. Trimming the tip cartilage alone usually gives one a mild few degrees of upward tip rotation and tip narrowing. The upperward rotation is usually so mild that it does not appreciably shorten the nose. The... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Rhinoplasty to Imrove Droopy Tip but Have Concerns How Tip Rotation Will Look on my Face

I have performed Rhinoplasty for over 20 years and there are degrees to which the tip can be rotated upwards. The nasal tip can be thinned and rotated slightly into a more aesthetic position, IMHO. The problems that I have always had with computer inaging are as follows: The computer manipulates the tissues in a manner not achievable during the Rhinoplasty and as such is misleading at best. Anyone that can run the software can get a good result on the computer... more

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Rhinoplasty

Without seeing you in person more detailed before pictures from many angles, it is impossible to give you specific advice. However, you do look like a good candidate for rhinoplasty to make the changes that you are looking for. Good Luck.

David Shafer, MD
New York Plastic Surgeon

Nasal tip motion (drooping) and tip definition can be corrected without shortening the nose..

Hi. The trick is to prevent the muscle that pulls your nasal tip down from reattaching, and this is best done with a little graft. And you could use slight rotation and tip sculpturing. Of course, your nose should not be shortened. see video

George J. Beraka, MD
Manhattan Plastic Surgeon

Changing your tip

The key to your request for correcting a droopy tip is to make subtle changes without overly narrowing or raising your tip. It is likely that you may need just a touch of tip cartilage trimming to make them equal. Some tip defining sutures and a special support graft will further refine the shape and give support. The more important part of the procedure for you may be adding strength and support to the tip in order to keep it where it should be during smiling. Meet with a... more

Michael Suzman, MD
New York Plastic Surgeon

www.westmedgroup.com

Nasal improvement

Come in for a personal consultation. We can do what you want and show you pictures how this has improved other peoples noses. Internet info won't help. Be seen in person.

William B. Rosenblatt, MD
New York Plastic Surgeon

I would recommend in personal consultation

You can achieve the improvements with the rhinoplasty,but it may involve more than just tip refinement. You can get a better answer after consultation and computer imaging.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Should work well!!

Based upon your photos--frontal view only--it should be a very satisfying adventure for you to have a rhinoplasty. Lifting or rotating your tip will be an esthetically pleasing effect, and while those surgical manuvers are being done, the muscle that pulls your nose down while smiling can be released to reduce that effect. Good luck!

Reginald Rice, MD
Sacramento Facial Plastic Surgeon

Tip Rotation and Projection

Hi, You can definitely achieve rotation and projection without loosing length. The tip cartilages have to be reshaped with cephalic strip and a dome division procedure. You should also have a strut graft and shield graft to keep the rotation and length of the nose. Computer imaging will show you what your results would look like, so make sure you have that. Best, Dr.S.