Droopy tip 18 months after 2nd Rhinoplasty. Any suggestions? (photos)

I had a revision rhynoplasty 18 months under local. The tip still droops down, especially when I smile. My Dr. said he would need to take more off of the tip to fix it, but it will change the look of my face, which I was trying to avoid. I am afraid to get more off of the tip, I think it will be too small. Will taking some more off of my tip help, or should I see another doctor?

Doctor Answers 2

Persistent Droopy Nasal Tip after Revision Rhinoplasty

Tip support and dynamics are complex with respect to the appropriate technique for correction of a droopy nasal tip following unsuccessful attempts initially. From your photos, it appears that your nose is too long overall and your lower lateral tip cartilages are too long and lack structural support at your primary and secondary surgeries. In my view, cutting depressor muscles or repositioning your cartilages on your septum will likely not be enough to correct the forces acting on your nose which result in the droopy appearance in the first place. You will likely need an open approach rhinoplasty revision in order to modify your tip cartilages, and cartilage grafts and reposition your tip properly. Your caudal septum may also need to be modified. A second opinion and computer imaging studies may offer you clarity in deciding if the changes you seek will be consistent with your cosmetic goals of not changing the look of your face. Even well done and natural revision rhinoplasty results may be more that you are willing to consider with regard to facial harmony and balance. I would search for an expert and schedule a consultation to review your situation. Best Regards. 

Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Droopy tip after Rhinoplasty

Thank you for the question.  Droopy tip can be fixed by usually adjusting the tip cartilages or by raising the tip onto the septum.  However, if we are trying to avoid changing the tip, then trying to raise this onto the septum might be an option.  Another issue is the depressor septi muscle; this is the muscle that pulls the nose down when you smile.  Many surgeons will cut this muscle to keep it from pulling down when you smile. Maybe ask about that as well. 

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 49 reviews

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