Is it possible to just cut the bottom part of the tip of the nose?

Question

I’m sorry I don’t know a lot about rhinoplasty. I was wondering if since I have a hooked nose when I smile, if you are able to just cut it off because I have pushed the bottom up and it stays the way I want – where my nose doesn’t effect my smile. Thank you for your feedback.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation. Often the best way to address the drooping nasal tip involves a cartilage graft and other techniques to help with cephalic rotation of the tip.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   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

Andrew Miller, MD · Answer

With the nose, you can't just simply cut off the bottom of the nose. However, the cartilage can be reshaped and strengthened so that the tip is no longer droopy and doesn't fall when you smile either. Be sure to see a rhinoplasty specialist for consultation.

Vito C. Quatela, MD · Answer

It seems that what you are describing is a dynamic tip. There is a muscle called the depressor septi nasi that can accentuate the tip while smiling, and occasionally while talking. This would need to be modified in order to change that quality of your nose. Nasal tip surgery is far more intricate and thoughtful than merely removing the tip. Through nasal tip surgery, there would be modifications made to the tip that may shorten its length or narrow it, but these are done in a manner that is mindful to the other components of your nose. Alternatively, if the tip movement is your sole concern with your nose, you can try a small amount of Botox in the muscles that animate the tip to dampen some of its movement.

Jennifer Parker Porter, MD, FACS · Answer

It is possible to change the droopiness of the tip without changing the overall appearance of the tip.  Rather than cut off the portion that is droopy, it is repositioned and supported so that when you smile the tip doesn't dip down.  Additionally, when not smiling it will not appear droopy.  When this is accomplished the tip will feel much more firm and supported.

Samir Undavia, MD · Answer

Yes. I think what your describing is a columelloplasty and removal of the depressor septi muscle.  This will decrease how much your nose hangs down and it shouldn't hook as much when you smile. Good luck!

Reza Momeni, MD, FACS · Answer

NO it is not, if you wish to not have a large scar there to show where it was cut off.  What you're asking for is accomplished with a tip elevating rhinoplasty, which is done by working on the inside of the cartilages.

Frank Scaccia, MD, FACS · Answer

That is a common question I am asked.  The hanging tip can usually be easily corrected by exposing the tip cartilages and then altering their size and position .   Sometimes a graft from your septum is needed for support.

William Portuese, MD · Answer

A full set of facial photographs are required to make a determination about being a candidate for a partial rhinoplasty procedure. A columella-plasty can accomplish trimming excess skin and cartilage from that area of the nose. To prevent the tip of the nose from drooping when smiling requires releasing of the depressor septa ligament. For many before and after  rhinoplasty examples and more information, please see the link and the video below

Jeffrey H. Lee, MD · Answer

Hi and thanks for your question.  The answer is that you can do anything in rhinoplasty but the real question is what is the best surgical maneuver that will help you achieve your goals.  Sometimes this is cutting a part of the cartilage that makes the tip, sometimes it's elevating the tip, sometimes it's refining the tip.  All things you should discuss during an in person consultation.  Good luck!

Is it possible to just cut the bottom part of the tip of the nose?

Answers (9)

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