Will depressor septi release alone correct my plunging tip when smiling? (Photos)

Hello,Although a premaxillary implant might improve your labial-columellar angle a tad, it will make your overly projecting tip even more projecting. Although your current angle on repose is 90 degrees, you aren't really in neutral position given the relative position of your entire tip complex is below your alar base. Your tip structure would make a primary structural rhinoplasty that shortens and de-projects your nose a relatively easy job, and would improve both your static and dynamic (plunging) labial-columellar angle. Go visit a few ABPS certified/ASAPS member surgeons (or their AAFPRS equivalents) who specialize in rhinoplasty.  Best of luck! 

Hello and thank you for your question. Based on your
photograph, you may benefit from a combination of techniques to add more support for your nasal tip including depressor nasi septi release, angulated caudal septal trim, and possible columellar strut graft.  This combination can result in a cephalic rotation of your tip to turn
up your tip slightly and prevent it from drooping with smiling.  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

We do not use "depressor septi release" during rhinoplasty to correct the appearance of a dependent and droopy nasal tip. You appear to have a long nasal appearance, and an acute nose-lip angle even when you are not smiling. Nasal tip-plasty with reconstruction of your nasal tip cartilages in a more pleasing configuration may be worth considering, along with consulting with several rhinoplasty specialists. Hope this helps! Dr Joseph

Usually the tip of the nose needs help as well as the muscle pulling down on the tip.  The nasal tip is not properly attached to the remainder of the nose.

Rhinoplasty to feminize the masculine face. Your nose is too long and large for your face. Cutting the muscle will not shorten your nose --it will only keep the tip from dropping as far.

Thank you for the question and the great photos! Release of the depressor septi muscle can help with the downward pulling action on the tip of the nose that occurs with smiling. However, it is not sufficient to lift your nasal tip. Generally when the tip is ptotic (droopy) or under-rotated, efforts to lift the position of the tip cartilages relative to the front of the nose and septum are required. This may include use of a columella strut cartilage graft or a technique called tongue-in-groove, where the tip cartilages are lifted and secured to the nasal septum. Best of luck moving forward!

Although removing/releasing the depressor septi muscle would be an important part of any rhinoplasty procedure, I am not sure that doing that by itself would be enough. Although it is hard to tell with out seeing your head in full view, it appears your tip is "statically" somewhat droopy and thus would require some minor tip rotation work to achieve what you are looking for.

The restricted views you submitted do not allow full analysis but on smiling the tip is pulled down with a horizontal upper lip crease due to the depressor septi nasi action and the nostril cheek junction is pulled upward by the levator labii superioris alaeque nasi action. Both muscles need to be addressed to resolve this but without a full exam it is impossible to know if just doing that would be a good option.

Thank you for your questions and photos. It may not be enough to just release the muscle. Adding tip support can be very helpful as well to address this issue. A consultation is important to determine what you need and the best way to do it

In most cases, the depressor muscle needs to be removed and additional tip support added with a cartilage graft. This is not always the case but the most likely scenario. Best.