What can be done to relax the depressor septi muscle? Droops when I smile (photos)

Question

I wanted to know what options are available to relax the septi muscle. I dont have an issue with my nose profile how ever when i smile it droops and i hate it ! it completely changes my face one side is worse the other. Can i have surgery to cut the muscle? or do i have to have a full rhino to fix this problem permanently ? thanks in advance

Ronald J. Edelson, MD · Answer

If you don’t want a full rhinoplasty it is pretty simple to raise the tip by strategically removing some cartilage and mucosa from the lower end of your nose. Perfect for a closed rhinoplasty but bear in mind that not all plastic surgeons are familiar with the procedure. No cartilage grafts whatever you do. That’s not the answer

Nima Shemirani, MD · Answer

Hi @Loving120084! Thank you for sending your photos! A non-surgical approach can be achieved with Botox by relaxing the depressor septi nasi muscle. However, this is only a temporary fix. If you are looking for a more permanent fix, I recommend a rhinoplasty.  I would not recommend cutting the muscle since this can cause the upper lip to look long and stiff.

Gurkan Kayabasoglu, MD · Answer

Hello. I have described the medical name of this problem you mentioned as Japanese greeting and I have been explaining the surgical technique related to this as dynamic rhinoplasty in congresses for years. Problems that do not arise when we are stable, increase more when we talk and laugh. We operate on people whose nose moves up or down. Please review our RealSelf and instagram accounts. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile. You can also book an online consultation and discuss your problems with me. With all respect.

Zoran Potparic, MD · Answer

This is a rudimentary muscle and it does not have to be present in every person; sometimes it is present only on one side. To be sure that is the only reason for your smile issue, one can try injection of Botox. This, however, needs to be done by an experienced, board certified plastic surgeon, expert in rhinoplasty, not every "injector". Good luck.

Eric M. Joseph, MD · Answer

In our experience, when someone has a droopy nasal tip that exacerbates the appearance of a dorsal hump, rhinoplasty surgery may be the best course of action. We do not ever cut the depressor septi muscle, and as an isolated procedure, I doubt this would lead to the results you want. Hope this helps. Dr Joseph

George Bitar, MD · Answer

The depressor septi nasi muscle can be treated nonsurgically with botulinum toxin injection to inactivate the muscle.  The botulinum toxin will wear off in 3-4 months and will require repeated injections to maintain the effects.  For a more permanent solution, the depressor septi nasi muscle can be cut from inside to mouth to avoid an external scar.  This will undoubtedly weaken the muscle, but sometimes the ends of the muscle will still scar together, resulting in some motion still.  I would recommend consultation with a board-certified plastic surgeon to discuss the options.

Tanveer Janjua, MD · Answer

Droopy tip and depressor septi muscle
The muscle can be cut easily without even entering the nose. You can approach it from under the upper lip to isolate and cut it. This reduces or eliminates the pull on the tip when the smile muscles are activated.
It also loosens the mid upper lip and it can fee a bit stiff. 
Regards
Dr. Janjua

Milan Doshi, MS, MCh · Answer

Thank you, Loving120084 for your question and photographs.
 Photographic evaluation is incomplete without personal examination to give the most appropriate answer
 However from the photographs, it seems that,
You have a groove which is due to the hyperactivity of the depressed. At times the muscle can be released surgically under local anesthesia and you will also get little tip elevation and tip projection if you need to change projection then this is sufficient and if you need to change your nose shape then rhinoplasty. Hope this information helps you.

Please consult a board-certified plastic surgeon near you and discuss this in detail.
Wish you an alluring look.

Thomas Spalla, MD · Answer

You could try neurotoxin (e.g., Botox) to the muscle to prevent this from happening. If this solves your concern, then this could be repeatedly performed. Or, if you like the appearance from this but desire a permanent change, yes, the muscle can be transected. 
If further tip elevation is desired despite the injection, then, a rhinoplasty may be in order.

Robert Ciardullo, MD · Answer

Addressing a Droopy nasal tip: The depressor nasi septi can be cut, but this may cause the upper lip to appear long and stiff, and the smile resemble that of a monkey. The alternative is doing a rhinoplasty and elevating the tip and supporting it either to your existing septum or if that is too high to a septal extension graft. This will elevate the tip without affecting the smile and the upper lip.

What can be done to relax the depressor septi muscle? Droops when I smile (photos)

Answers (12)

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