Is the Entire Depressor Septi Muscle Supposed to Be Disconnected During Rhinoplasty?

My doctor "released" (he said it was not cut?) the entire depressor septi muscle during rhinoplasty. I am unhappy with the changes it has caused. The skin in my lower face (from my nostril to the upper lip is now very loose. The doctor agreed that the changes did occur and said he can reconnect it. Is this possible?

Doctor Answers 5

Interruption of the Depressor Septi Muscle in Rhinoplasty

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I'm sorry you've had undesirable changes to your upper lip after rhinoplasty surgery. However effective reconnection  the deperessor septi muscle is not surgically possible. Talk to your surgeon about what can be done to improve the appearance of your lip.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Changing of the upper lip following Rhinoplasty

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In answering your question, it would be critical to know just how long ago you had rhinoplasty.  Your feeling of "looseness" between the upper lip and nostril could in fact be related some temporary numbness in this area that you get following rhinoplasty.  If the appearance of your upper lip is changed with smiling or animation it can sometimes be due to a columellar strut (cartilage graft) that may have been placed during the procedure.  While some of the fibers of the depressor septi muscle are generally cut or released during any rhinoplasty which involves an incision in the anterior septum, the surgeon would have to go out of his or her way to have prevented some reconnection of these fibers with closure of the incisions that would naturally occur over time.   Surgical reconnection of this muscle would not be necessary or in my estimation possible.   Depending on how long ago your rhinoplasty was, you may want to give it more time, revisit these issues with your surgeon or get a second opinion/physical exam from an expert rhinoplasty surgeon. 

James C. Marotta, MD
Long Island Facial Plastic Surgeon
4.8 out of 5 stars 87 reviews

Can The Depressor Septi Muscle Be Reattached If It Has Been Released From A Rhinoplasty?

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Once the depressor septi muscle has been released and/or cut, it is unlikely that it would be able to be reconnected. This is because once the muscle is released, it contracts and shortens. This would make reliably finding the ends of the muscle to be put back together very unlikely. However, it may be possible to reattach the tissues underneath the lip back to the anterior nasal spine with a suture. This may, or may not, grab some muscle. Either way, the feeling of a loose upper lip may be able to be improved. 

Depressor Septi Muscle Disconnection During Rhinoplasty

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The depressor septi muscle is often detached from it's boney connections during rhinoplasty to keep the muscle from pulled down the tip of the nose during the recovery period.  The muscles usually re-attach after a few weeks.  Hope that you love your new nose.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Is the Entire Depressor Septi Muscle Supposed to Be Disconnected During Rhinoplasty?

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The depressor septi muscle in certain patients causes nasal tip depression ,because of its variant insertion into the nasalis muscle thus also shortening the upper lip on animation.In those patients I perform transposition of the muscle  thus achieving slight lengthening and upper lip fullness and a "stable " nasal tip.

You don't like the change to your upper lip ,go back to your PS and discuss a potential correction.

I don't think that "reconnection" is an option. Depending on how far out you are after your surgery ,the muscle is propably scarred and contracted by now.

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.