Bump on tip of nose after dorsal hump removal. Is it a possible depressor septi issue? What'll help resolve this issue? (photo)

Question

I had rhinoplasty to remove dorsal hump 3 years ago. I am mostly happy with the results, but whenever I move my upper lip down or smile, it pulls down the tip of my nose and shows a bump (I'm assuming cartilage). Would cutting the depressor septi muscle, or even using botox on it, help to resolve this issue?

Julian Rowe-Jones, MBBS, FRCS (Eng), FRCS (ORL) · Answer

This muscle can pull the tip downwards and also backwards highlighting the cartilage of the corner of the septum.  Cutting the muscle can sometimes help and this could be rehearsed with botox.  Sometimes the tip needs to be fixed with grafts or on the septum so it cannot move.  This will make the tip feel stiff.

Carlos Castaneda, MD · Answer

Looks to me that the cartilage graft usually used to refine and shape the tip has movedThis correction would only be possible through a revision surgery, but wait at least once 6 months have gone by so the tissue can be operated on safely

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