Is there a rhinoplasty technique which can fix a plunging tip other than a strut graft?

Before my rhinoplasty my tip would plunge a bit when smiling. The surgeon Sam Naficy put in an extended strut graft. Also a tip graft of some sort. It feels stiff and hard, like I have a stick in my nose pulling the skin tight. I do not want a rock hard, painful nose. I also did not want it projected. Will making it shorter make it less painful? Or should it be removed altogether?

Doctor Answers 4

Rhinoplasty for droopy tip

 A  Revision rhinoplasty procedure can accomplish lifting the droopy tip without a strut graft. It is important to understand what has been accomplished in the past with previous cartilage grafts, and a complete set of facial photographs in addition to an in-person examination. Revision rhinoplasty is harder than a primary rhinoplasty. To prevent the tip from drooping when smiling requires releasing of the depressor septi ligament.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Strut graft issue

You would have to be seen in person to determine what the issue may be. Best of luck with your rhinoplasty result.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


Hello and thank you for your question. There are many options for fixing a dropping tip and also many ways to revise an overly stiff columellar strut graft.. 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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

Rhinoplasty technique

There are a number of techniques and each is based on the specific needs of the individual case. The columellar strut can be shortened, removed, or altered in other ways which may help with some of your symptoms. By shortening it you may loose some tip support so another technique may need to be employed. I would recommend visiting in person with a revision rhinoplasty surgeon who can review your operative report and examine your nose to determine the best course of action.

Best of luck

David Reinstadler, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 13 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.