Will tip drop with dorsal hump removal? (Photos)

Question

hi there! i have some questions regarding the appearance of the nose tip. if i were to get a rhinoplasty where only the dorsal hump is removed, will the tip drop even if its not operated on? secondly, should i lift my tip or not. some days it looks really nice, but some days it looks super droopy. my nose in specific has a lifted angle, but i have just a bit of droop towards the very outer projection of my nose. im wondering if i removed my dorsal hump if my tip will kind of come together? but in the case of it dropping even after dorsal hump removal is it worth it in my case to lift the tip? i definitely want it to be supported though. heres my photos!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D. FACS
Harvard-trained board certified plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D. FACS
Harvard-trained board certified plastic surgeon

Ronald J. Edelson, MD · Answer

I typically raise the tip a little in most cases where the hump is removed. It’s very simple to do and makes a really nice improvement. Often if raising the tip is not done the nose can appear too long

William Portuese, MD · Answer

The digital imaging photographs, you presented are very accurate and realistic, by a very experienced rhinoplasty surgeon. It's very important to also it is important to understand that you must undergo a full rhinoplasty which accomplishes narrowing the nasal bones after the hump removal, otherwise You'll end up with a open-roof deformity. Your tip may need a little bit of work to make sure it's in proportion to the new more narrow bridge line. Usually the tip raises slightly with a hump removal, but it also depends upon what is being done with the tip as well. Since rhinoplasty is the most difficult procedure to perform in the entire field of cosmetic surgery, it's best to choose your rhinoplasty specialist carefully. Study your prospective surgeon's rhinoplasty photo gallery and make sure it is extensive with natural results that you like.

Kyle Kimura, MD · Answer

Thank you for your photos and questions.
In general, the tip should not drop with dorsal hump reduction if a rhinoplasty is performed correctly. The question about whether you want the tip lifted or not depends entirely on your preferences and I think is best demonstrated in the simulation photos you have provided. 
Your best option is to discuss these questions with a plastic surgeon experienced with rhinoplasty that can have a more nuanced discussion about these questions and what is the best option for you.
Hope this helps and best of luck,Kyle Kimura, MD

Zoran Potparic, MD · Answer

It would be difficult to make prediction based on photos only; in person evaluation is needed. Tip shape and position after hump reduction is reevaluated in surgery and additional steps like tip shaping and support are added as needed. However, in some cases surgeon may leave tip unchanged if its relationship with the rest of the nose is favorable. Good luck.

Randal Haworth, MD, FACS · Answer

Photos can only show so much, but the short answer is that the bridge and the tip are not independent of each other. When a dorsal hump is lowered, the tip can look more projected, or in some noses it can lose a little support and settle, depending on how strong the tip cartilages are and how firmly they are attached to the septum and to each other. That is why a hump reduction is rarely planned as a bridge-only operation. A tip that looks lifted on some days and droopy on others often points to soft support at the front of the nose, or to a muscle that pulls the tip down when you smile and talk. Whether the tip needs lifting, or simply stabilizing so it keeps the rotation you like, is decided from your profile at rest and smiling. An in-person evaluation with a surgeon who does a great deal of rhinoplasty is the sensible way to settle it.

Will tip drop with dorsal hump removal? (Photos)

Answers (6)

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