8 months Post primary Rhino tip issue - droops when smile. Any suggestions? (photos)

My tip appears to droop more when I smile than before I had rhino. What causes this & can this be fixed and the tip made less pointy ? Also can the actual profile be lengthened since, I feel it's too short for my face now ? Please can you see any other issues that I can improve ? overall in unhappy with my results

Doctor Answers 3

Droopy tip 8 months post rhinoplasty

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Hi LET123,

Based from  your photos, I agree that you have a drooping tip and it becomes more apparent when you smile, due to the action of the depressor septi muscle that pulls your tip down when you smile. Your request to lengthen your nose will further aggravate the drooping. Adding projection to your tip and a little upturning will correct the drooping. 

Thailand Facial Plastic Surgeon
4.7 out of 5 stars 17 reviews

Revision rhinoplasty

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Thank you very much for posting so many pictures.

Yes the tip is hanging because it is not attached to the bridge as before. There is not much definition and looks a bit too round.

You are an excellent candidate for an open rhinoplasty with "tongue in groove" technique to re-suspend the tip to the septum in an higher position and more projected.

The open technique is perfect to do intra- and trans-dome sutures to achieve more definition of the tip.

I usually show my patients plenty of before and after photos for each specific technique I recommend.

It is good habit to visit your surgeon two or three times at consultation before proceeding with revision surgery - in particular for rhinoplasty.

I hope you find this useful and I wish you all the best with your revision rhinoplasty.

Best regards,

Stefano Cotrufo, MD, PhD
London Plastic Surgeon
4.9 out of 5 stars 37 reviews

Seems to me that your nose is still too long.

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See the "Web reference" link, just below my response. I made a couple of computer morphs of your nose, and an animations of the morphs, to show the changes that are possible for your nose in truly expert hands.

Mostly, I elevated the tip of your nose. The photos that you posted were smiling photos, and when someone smiles, the tip of the nose tends to droop more, but your nose still looks kinda long to me. 

You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a revision rhinoplasty surgeon, and how to tell whether your primary surgeon should perform your revision. You don't want to be in the position of looking for a third operation.

Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. Then, he must show you before and after photos to prove that he can actually accomplish what he draws on the computer.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 42 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.