Does the Tip Drop After Rhinoplasty?

Question

I'm getting my nose done. I told the doctor that from the profile,I do not want a straight nose; neither do I want a piggish nose with too much of a curve just a slight curve. Everyone says I should get more curvy nose done because the tip drops. Is this true or does the nose stay looking the same forever after the swelling goes down?

David C. Pearson, MD · Answer

Some surgeons employ techniques that count on the tip dropping after rhinoplasty. The problem has always been one of predictability. Most current techniques try to limit the amount of post-op tip drop by using strut grafts and suture techniques to predictably place the tip.
The only sort of exception to this may be to note that for the first week or two after rhinoplasty, the nose can look a bit jacked up at the tip from swelling at the base of the columella. But this effect should quickly resolve in the first couple of weeks post-op.
All the best,
--DCP

Richard J. Bruneteau, MD · Answer

It’s not unusual to see changes in the nose in the immediate post-operative period. This occurs for a variety of reasons including the healing process and the resolution of swelling.
                When surgeons perform rhinoplasty they utilize a series of detailed maneuvers on the underlying bone and cartilage. In the initial post-operative period, these changes are often obscured by inflammation and swelling. In some cases, as swelling resolves and nasal contour improves, the nasal tip may actually appear to drop. The nasal tip should be more or less stable after the resolution of swelling. 
  
                If you’re considering rhinoplasty it’s important to consult a board certified plastic surgeon with experience in this area. Make sure he understands your aesthetic goals. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Thomas Buonassisi, MD · Answer

Drooping of the tip was a common problem after Rhinoplasty many years ago. Today, Rhinoplasty specialists take important steps to provide excellent long term stability to the tip to prevent drooping. I often tilt the tip slightly more than is ideal at the time of surgery as I expect it to drop slightly post operatively.

Otto Joseph Placik, MD · Answer

The nose never look the same forever, As we age the support to the tip of the nose fails and the tip of the nose drops. That is a natural consequence of aging.
When it comes to surgery, swelling and fullness in the tip of the nose may make it appear as if the head is turned up and many people complain of an overly upturned nose eary on. As the swelling subsides, it appears that the nasal tlp drops.

Toby Mayer, MD · Answer

An experienced rhinoplasty surgeon takes this into account when he does the nose. He does not overdue it to give an artificial, done look to the nose.

Kevin Ende, MD · Answer

Unless a surgeon performs certain maneuvers during surgery that may lead to lack of tip support, the nasal tip does not typically drop over time from most Rhinoplasty procedures. You should discuss this with your surgeon during your consultation.

Michael A. Persky, MD · Answer

Hi Antoinette,
The nose continues to change for years after rhinoplasty. It is most important that your surgeon leave a stable foundation of bone and cartilage so that as the nose evolves over time, it does not "shrink-wrap" into a "done, pinched" nose.
An experienced rhinoplasty surgeon will take into account the changes that the nose undergoes over time during surgery to create a nose that stands the test of time. Communicate what you want and hopefully your surgeon will be able to achieve those goals.
Good luck and be well.
Dr. P

David Mattos, MD · Answer

Good question. A lot of these changes are visual effects because the tip is the area with the swelling that lasts the longest, so  as the swelling goes away over months, it sometimes appears different over time. However, if you look closely at the nasolabial angle, you will see that it's pretty stable long term if done with good technique. I would not recommend over-scooping the nose to get the nose to settle over time. I would trust your surgeon who does the procedure all of the time, not your friends unless they are also surgeons with experience doing the procedure and following patients in recovery. They may have good intentions but may be misinformed. 
-Dr. David Mattos, New York Plastic Surgical Group

William Portuese, MD · Answer

It is important to have a very clean aesthetic nose with a strong bridge profile and a very small curve just prior to the tip.  The supratip depression is an important area of the nose that allows definition between the bridge and the tip so that the whole nose just does not run together on the dorsal aesthetic line.  A piggish nose is unacceptable and gives the look of having had a nose job.  There are many subtle changes that occur between the first month and twelfth month after the rhinoplasty procedure.  After the first year when all the swelling has resolved, the nose will no longer undergo any changes. For many before and after examples of closed rhinoplasty, please see the link and the video below

Steven Wallach, MD · Answer

TIp dropping after a rhinoplasty was more common years ago when sutures were not used to contour the tip. I think today, tips tend to stay where they are because better support is provided during modern rhinoplasties.

Does the Tip Drop After Rhinoplasty?

Answers (11)

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