Nose Tip Droops when Smiling, is This a Hyper Active Muscle?

My nose tip droops a little anyway but that doesn't really bother me. When I smile it droops down a lot and my nostrils also seem to flare. Is this caused by a hyperactive muscle and can it easily be fixed?

Doctor Answers 8

Drooping tip of nose when smiling

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Nasal tip droop when smiling is usually caused by muscular contraction, and can be corrected by weakening or cutting that muscle.  Sometimes this can be performed under local anesthesia in the office if no other maneuvers are needed (a physical exam is necessary to determine this).  Sometimes an injection of Botox/Dysport can yield a favorable result, and not commit you to a surgery or permanent change.  Be sure it is an absolute droop, rather than a relative droop (i.e. the tip appears that it droops only because the lip itself is contracting and changing shape around the nose, when the nasal tip in fact does not actually change- that's a different situation).  This is fairly straightforward- you don't necessarily need to find a surgeon with "elite" credentials- just a surgeon who is board certified in general plastic surgery or facial plastic surgery, and they will let you know if they are comfortable dealing with this issue.  Hope that helps!

Paoli Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Rhinoplasty for drooping tip

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 The cause of a drooping tip upon animation is the presence of an active depressor septa ligament. This ligament can be released at the time of the rhinoplasty. Lifting the drooping tip can also be accomplished with cartilage grafting to give more tip support as well. Please see the  link below for examples of droopy tips we have repaired in our practice

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Cause of Nasal Tip Droop When Smiling

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The nasal tip drooping you describe when at rest or with smiling can be caused by weak structural cartilage support and/or the pull of a small muscle at the base of your nose. Both problems can be improved with rhinoplasty surgery and cutting that muscle.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Nose Tip Droops when Smiling, is This a Hyper Active Muscle?

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          This drooping during animation can be caused by muscle contraction.  This can be released in a simple surgical maneuver.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Nose Tip Droops when Smiling, is This a Hyper Active Muscle?

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A drooping nasal tip at rest is due to inadequate tip support. However, many people also see their tip drop with smiling. The best solution is a combination approach where structure is added to support and reposition the tip and removal of the muscle that pulls the tip down with smiling. These are common maneuvers that are performed during rhinoplasty. I hope this information is helpful.

Stephen Weber MD, FACS

Weber Facial Plastic Surgery

Fixing a droopy nasal tip may simple by treating the muscle or it may require surgery

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Drooping of the nasal tip may be from an overactive muscle called the depressor nasi. Relaxing that muscle with Botox may do the trick. However, a drooping nasal tip may also be due to weak cartilages or cartilages that are angled so that they actually push the tip of the nose down. In that case, a tip rhinoplasty is the best bet for raising and supporting a drooping nasal tip.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Drooping of the Nasal TIp

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Improving nasal ptosis (or drooping of the nasal tip) when you smile is a common request.  This is likely caused by your muscle pulling down on the nose with smiling and can usually be corrected.  However, weakness of the nose may also be contributing to this.  An in-person consultation is recommended with a board certified specialist who can assist you in achieving the results you seek.



Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

What causes a droopy tip when you smile?

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Dynamic changes in tip position with smiling can be due to a few things.  It may or may not be the muscle.  It sounds like you have a droopy tip to start with, which indicates poor support of the tip itself.  When you smile, the lip skin exerts some force on the tip, as does the depressor septi muscle.  Either or both could be contributing.  Rebuilding tip support can be relatively simple or challenging and may require any of a number of techniques.  For this reason, an experienced rhinoplasty surgeon should examine you to determine how best to treat this, if you wish to do so.  Treatment may require fixing the 'droopiness' at rest, as well.  Hope this helps.


Dr. Most

Sam Most, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 69 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.