Nose drops when I smile, should I reconsider a rhinoplasty? (Photos)

Hello and thank you for your question and the pictures. Addressing the shape of your nose (especially a drooping nasal tip) is actually one of the most common reasons people seek out and undergo a rhinoplasty. An open septorhinoplasty can best address both your aesthetic concerns and any functional issues with your nose. I would be able to adjust the size, shape, and definition of your nose (particularly the tip), and correct the drooping issue!

This truly is a surgery of millimeters- and whether you're looking for a minor adjustment or a major transformation, it requires exceptional surgical skill to achieve functional and natural-looking results! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading rhinoplasty experts (who performs 1,000+ nosejobs annually).

I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

A rhinoplasty that is well performed would certainly give you a permanent improvement in the shape of the nose which would also be an improvement in the droopiness you get when smiling. If surgery is not desired, then some filler can be placed in the tip to give it the appearance of being lifted and a little botox placed in the depressor muscles under the nose. Be sure to see an expert rhinoplasty surgeon for consultation.

Based on your photo, your bridge appears to be a bit High, and I agree that your tip droops with smiling and it gives the appearance of a dorsal hump. If this is something that bothers you, rhinoplasty surgery may be considered for achieving a less distracting and more feminine nasal profile appearance. I do not believe that there is an adequate non-surgical procedure to address your concern. Thank you so much. Sincerely, Dr Joseph

Hi. Depresor septi muscle can lower the nasal tip when you smile. And in this situtation we are performing a touch on this muscle. And if we continue to your nose, some nasal dorsal bump and some bulbous tip. Depresor septi muscle approach and rhinoplasty can be done in the same surgery. You can reach us for information and evaluation purposes. We wish you healthy days.

Hello,

There are some different options that are worth exploring. Botox to the depressor septi can help prevent the nose from depressing especially with smiling. The solution from a surgical stand point is to make the nose have more support so it can withstand the muscles. There are some surgeons that cut the muscle but I do not believe that. I prefer to support the muscle instead. Good luck in your exploration!

This is a normal variation of what happens when some people smile due to a combination of several muscles in the face when animating. A rhinoplasty is the best way to address a "droopy tip", especially if it is exacerbated with smiling. You would do quite well with a rhinoplasty.

One option which you may want to consider is neurotoxin (e.g., Botox). This quick option can help weaken the muscular pull of the nasal tip in the downward direction. If this is satisfactory for you, there are techniques to transect (i.e., cut) that muscle to achieve a long-term effect rather than continued neurotoxin injections.

Hello and thank you for your question. Based on your photographs, rhinoplasty is definitely the best way to fix your tip drooping with smiling. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. With good surgical technique, you could 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

A plunging tip is generally due to an over active depressor septi muscle that is at the base of the nose. This can be addressed temporarily with botox injections, however the only way to definitively treat this is the release the muscle. This can be done during a rhinoplasty, while also addressing any other concerns you may have about your nose. Release of this muscle does not cause any changes in your facial animation or function, however it will prevent the nasal tip from drooping with smiling.
Sean M Fisher MD

You can undergo a very minor surgical procedure to release the depressor septi ligament which dynamically pulls your tip down when smiling. This is just a small ligament at the base of the nose just above the teeth. Alternatively, you could undergo closed rhinoplasty procedure with all the incisions placed on the inside of the nose which would accomplish shaving down the dorsal hump, refining the nasal tip, narrowing the bridge line, and releasing the depressor septi ligament all at one time under a brief general anesthesia as an outpatient procedure