Can you repair depressor septi nasi?

Question

I had rhinoplasty a couple of years ago and tip movement, upper lip and smile changed. My nose used to move a lot and is stiff now and now I have less tooth show. My surgeon cut the depressor septi nasi muscle. Is it possible to reattach or repair? I really miss my tip movement and natural smile. I dont want a lip lift. Thank you

Eric M. Joseph, MD · Answer

If the muscle at the base of your nose was cut, and if this has led to a permanent droopiness of your central upper lip with smiling, it is not clear to me whether further surgery would be able to attach the muscle back together for normal functioning.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Although it is not possible to repair the nasi depressor septi muscles, that is not likely the issue causing your problems. It fully depends on if your surgeon used rigid tip fixation such as an septal extension grafts or tongue-in-groove technique, then that could be corrected during a revision to give you a less stiff tip and more normal smile. With good surgical technique, you could likely have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Zoran Potparic, MD · Answer

It is very difficult to repair depressor nasi muscle even if you had one or both( it is very variable muscle not present in all people, and sometime only present on one side). Dynamic lip lift with excision of portion of orbicularis muscle may be quite a successful way to improve dental show and smile.

Gary M. Horndeski, MD · Answer

If the muscle has been cut and was done 2 years ago then the muscle will no longer be functional as it has atrophied. You also say you have less tooth show. I know you stated you do not want a lip lift. The trouble with a lip lift is it is often done in the sill, which is not the correct place, it should be done in the nostril and it needs to be an eccentric excision to pull up the corners, not just centrally. The typical bullhorn lip lift leaves a frowning type of appearance. I would need photographs to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Can you repair depressor septi nasi?

Answers (4)

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