How to Correct my Drooping Nose Tip?

When I smile, my nose tip droops down. I read about the depressor septi being cut but I think my doctor does not want to cut any muscle. he wants to attach a cartilige or something to the septum. Which way is better? My sister had the muscle cut and her results are good. Her nose tip no longer drooped, but that was 8 years ago and things have changed.

Doctor Answers 9

Everyone is different

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Cutting or removing the depressor septi muscle is one of many techniques used to decrease a droopy tip.  However, often that by itself is not sufficient.  Cartilage grafts and repositioning of the tip may be needed. You need to be examined by a rhinoplasty expert.  Your nasal tip may actually need to be rotated up a bit.

Boston Facial Plastic Surgeon

Correction of a Drooping Nasal Tip

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Thanks for the great question! Correcting a droopy or hanging nasal tip can result in a significant improvement in overall facial aesthetics. Cutting the depressor septi muscle during rhinoplasty can help in some patients, but this is not the primary issue for everyone. In a lot of cases, the septum is too long and it forces the tip downward. The septum can be trimmed and/or the tip cartilages can be rotated back and attached to the septum. These techniques result in rotation of the nasal tip upwards relative to the lip.

Rhinoplasty surgery may be considered for elevation of a droopy nasal tip.

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If you're a woman, an attractive angle between your nose and upper lip may be between 95 and 100 degrees. In our practice, we do not cut the depressor septi muscles. Droopy nasal tips are typically addressed by reconstructing the alar tip cartilages for a more pleasing appearance. We also add support to prevent drooping with a columellar shoring strut that may be custom carved from your septal cartilage. Hope this helps. Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Rhinoplasty, Beverly Hills Rhinoplasty, Nasal Refinement, Nose Job

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To answer the question of how to best treat your droopy tip, I'd have to see you or pictures of the nasal tip on profile, front and from below the nostrils looking up...both at rest and when you are smiling.  Droopy nasal toips can be from:

  • Enlarged upper lateral cartilages literally pushing the nasal tip doen (tension tip)
  • weak nasal cartilage that lacks the proper support and so it sags
  • a full angle of the anterior septum causing the nasal tip to point downward giving the illusion of drooping
  • any combination of above with active nasal muscle

To plan the best course of action during a Rhinoplasty one must first have a thorough evaluation, of the nose, to plan the appropriate corrective measures.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Drooping Tip

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Cutting the depressor muscle does help to inhibit tip drop with facial animation, as you saw with your sister. Discuss this again with your surgeon. Interrupting the muscle is an easy, minimally invasive procedure. The placement of cartilage at the end of your septum (we call this a strut) will help support the tip. If you're happy with the position of your tip when not smiling, this may not be necessary.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Non-surgical alternative

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A nice alternative to try before surgery is a small injection of Botox. A skilled physician who understands Botox and facial anatomy can put a small amount of Botox into the muscle and this can give you the "fix" you are looking for before turning to surgery.

As a facial plastic surgeon, I can recommend rhinoplasty as the more permanent alternative. Of course, cutting the muscle is one option but muscles do heal. There are pros and cons to putting a cartilage graft to elevate the tip. It really depends on your individual nasal tip. Factors like skin type, shape of your nasal cartilages, septal deviation can all play a role. You can try the Botox and schedule your consultation with an expert.

Yael Halaas, MD
Manhattan Facial Plastic Surgeon
4.8 out of 5 stars 43 reviews

Drooping nose tip correction depends

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The anatomy in siblings will not be exactly alike. What worked for one might not be the right thing for the other. Rhinoplasty is a very complicated operation. If you doubt what has been recommended to you, I would speak to other rhinoplasty experts before deciding.

Post photos and we can offer more advice.

Phillip Langsdon, MD
Germantown Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Closed Rhinoplasty for Droopy Nose

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The good news is that is there is a relatively simple and extremely safe approach to correcting this with our scarless technique.  The key is to rotate the nose upwards and prevent the excess pulldown when smiling. We utilize multiple maneuvers to carefully rotate the tip of the nose to lift it to an elegant height and design without any telltale signs of surgery. By doing this via a scarless (closed) approach, there are no external cuts ever on your nose.  This prevents the dreaded complication of external scarring at the base of the nose, which even if rare, if it occurs, is devastating.  Through a scarless approach you can accomplish almost everything needed to be done to the nose with no scarring, less healing time, less bruising, and less swelling. Consult with a board certified facial plastic surgeon for an in person consultation. 

All the best, 

Deepak Dugar, MD
Scarless Rhinoplasty Expert
Beverly Hills, CA 90210

Deepak Raj Dugar, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 20 reviews

Commonly performed

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The depressor septi muscle can be easily clipped at the time of the rhinoplasty surgery. When successfully clipped, the tip will no longer drop when smiling after the surgery. This is commonly performed and has no consequences to it.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.