Can I get a rhinoplasty without making my philtrum look longer?

Question

My nose isn't hooked, but the tip is underprojected, droopy and not sharp. Is there a way to make my profile sharper and less droopy without risking my philtrum looking longer? What techniques would a doctor use to achieve this?

Yannis Alexandrides, MD, FACS · Answer

Hi, 
Thank you for your question. 
It is absolutely not necessary to change the length of the philtrum when one is performing the Rhinoplasty surgery. For this reason, I can confirm, yes it is possible to have a Rhinoplasty procedure without changing the philtrum.

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question. Typically the philtrum length will not be altered with a rhinoplasty. Rotating the nasal tip to improve droopiness can expose more of your upper lip but it doesn't lengthen the philtrum per se. I could offer further advice if photographs are provided, with the caveat that an in-person evaluation is the most ideal.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Mark G. Albert, MD, FACS · Answer

Hello,
Thank you for your question. Tip projection can be achieved with a combination of tip sutures and cartilage grafting. Your philtrum should not be affected by these maneuvers. This can be done using the closed / scarless approach. I wish you all the best.
Mark G. Albert, M.D., F.A.C.S.New York, NY and Boston, MA

Muhammet Dilber, MD · Answer

When someone has a droopy tip and wants it to be less droopy and tip projected which is done by lifting and supporting a tip, philtrum always looks higher. If a tip is lifted for example 3 mm up then a philtrum will look 3 mm longer.

Zoran Potparic, MD · Answer

It is very difficult to address this question in general manner. Good rhinoplasty, performed by an expert, board certified plastic or ENT surgeon, should improve overall appearance of the nose. Some steps may be needed to avoid long looking philtrum (nose); they usually involve shortening of distal septum. Tip shape and position could be achieved with combination of tip cartilage shaping with sutures and cartilage graft(s) taken from septum. In person consultation is necessary for more detailed answer/recommendation. Good luck.

Ronald J. Edelson, MD · Answer

I would really like to see photos of your nose to give you further information. In general however the upper lip might lengthen a little if it's tight.

Robert Ciardullo, MD · Answer

Rhinoplasty for under projected nasal tips: it is difficult to assess your case without photos, but from the description you give you may have a short Columella. The columella is the strut between the two nostrils which helps support the tip. When the columella is short the dorsum of the nose and the area above the tip may project more than the tip itself. Reducing the projection of the dorsum and the supratip will make the tip appear better and more projected .however this type of nose which commonly is characterized by a short columella and plunging rounded tip will usually not produce a “pointy upturned“ looking tip , but a softer, less pointy, slightly rounder looking tip.

William Portuese, MD · Answer

A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. A closed  rhinoplasty accomplishes making the changes with all incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either.