Will bone filing without tip reshaping make my nose droop?

Hello,Based off of your pictures a small filing of the dorsal hump with sculpt your profile to the perfect balance. Your nasal tip is at a good angle that I believe will not be affected negatively by your dorsal hump filing. Trust your doctor's advice!All the best,Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

Hello and thank you for your question.  There are several aspects to your nose which I would recommend addressing in addition to what you have mentioned.  This combination can help prevent your nose from drooping.  Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. You may also benefit from a cephalic rotation of your tip to turn
up your tip slightly and a conservative dorsal hump reduction.  Spreader grafts can be performed at the same time.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Dear SGreenwich83 in Greenwich, CT:
The decision to use spreader grafts to solve a collapsed valve, which you may have is not perhaps as serious as if you had previous nose surgery should be addressed. Closed rhinoplasty is excellent, but I am not sure what you mean by, “can do some filing of the bone.” 

You are a great candidate for a standard rhinoplasty to remove the bump and perhaps narrow it.  I cannot tell from the front view if it needs narrowing.  The bit of hanging columella can be corrected, that is not difficult.  Grafting calls for some consideration before approaching it. 

You may consider having another consultation.  Consult with someone whose practice is nearly all rhinoplasty.  Luckily, you are close to New York City.  There are surgeons like that there.  You want to see the doctors’ photo gallery.  You want to closely examine their section on computer imaging showing the predicted result and the final result.  At consultation bring a friend or family member.  Prepare ahead of time a list of questions of the doctor.  The most important factors in selection of a cosmetic surgeon are:  (1)  Degree of specialization.  (2)   Volume of experience.  (3 & 4) The talents as manifested by the before and after albums, as well as the computer imaging section of the website. 

Best wishes,

Robert Kotler, MD, FACS 

Whilst I would agree with most of what my colleagues have said regarding closed rhinoplasty to correct the dorsal hump and typically this not causing any alteration to the tip, I would add that it is difficult to appreciate from the photos that shaving the bony dorsum will fully correct your dorsal hump. IMHO from the photos, your dorsal hump involves the upper lateral cartilages as well and this needs to be addressed with an open rhinoplasty. With the open approach, the dorsum, spreader grafts and the hanging collumelar can all be corrected.
I hope that this does not confuse the issue for you - speak again with your board certified plastic surgeon. Good luck

Dorsal hump reduction will not make the tip droop necessarily, but the answer depends on your tip support.  Without an exam, it will not be possible to fully evaluate you and give you recommendations. Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search. 

Try to get it right the first time.  Do not " tie up you surgeon's hands" to offer you the best result possible. You need tip work and elevation of it with caudal septal treatment and tip refinement. Best of luck.

Manipulation of the upper and middle thirds of the nose will not make the tip droop. A closed rhinoplasty comes ion behind the lower tip cartilages and does disrupt enough intercartilaginous ligaments to affect the position of the nasal tip.

 It's very difficult to determine the shape of the nasal to cartilages from only the side photograph. A full set of facial photographs required to make a determination about what needs to be performed during the closed Rhinoplasty procedure. The dorsal hump is composed of the bone and cartilage which must be shaved down in order to remove it and give a new dorsal profile. Osteotomies placed in the nasal bones are usually required after that to close the open roof created from the hump removal. The hanging columella is also reduced with a columella plasty. Spreader grafts and nasal tip surgery  can certainly be performed through a closed rhinoplasty approach. For many before-and-after examples, please see the link and the video below to our close rhinoplasty photo gallery.