Nose Tip Droopy After Second Surgery?

I had a first rhinoplasty (closed) 1 1/2 years ago to raise a droopy tip. Immediately after the bandage came off it didnt look any different. The doctor did a revision a year later (a few month ago) with a stronger graft. After surgery it looked perfect, but i'm a few months out now and noticed its starting to fall back to where it was... I cannot afford (financially and mentally) a 2nd revision, and i know fillers are just temporary... is ther anything that can be done for me?

Doctor Answers 7

Droopy nasal tip

Sorry to hear about your experience following surgery.  In general, the tip will drop slightly following a rhinoplasty.  This is due to the following things:

1) Gravity
2) The tissues "releasing."

Sometimes patients are worried that the tip is turned up too high, but this is a normal result of surgery.  It is possible your surgeon did not lift the tip high enough.  Furthermore, if the rhinoplasty is performed improperly, nasal tip support may be affected.   A few months is too soon to tell, and I would recommend waiting until you are further along in the healing process before coming to conclusions.  After a few more months, it would be a good idea to follow up with your surgeon and see what your options are. Thanks and I hope this helps!

Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 66 reviews

Options for Drooping tip

I would suggest you wait until at least six months before critically evaluating your results with your surgeon. Allow the tip to settle to its final postiion. With regards to options at that time, I dont think fillers are likely to give you any significant improvment in the position of your tip. They can fill it but have little effect on repositioning it upward.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 105 reviews

Correction of the Droopy Nasal Tip

There are a few ways to correct a droopy tip but surgery is generally required. As the other doctors in this forum have mentioned, fillers can add volume to the nose but likely wouldn't correct your tip ptosis to the degree which would make you happy. Surgical techniques include suturing your tip up to the septum (septocolumellar suture), shortening the sides your tip cartilages (lateral crural overlay), and trimming back your septum. Some of these can be done through a closed or endonasal approach whereas others may be better performed through an open rhinoplasty. I often place a graft between the tip cartilages, called a columellar strut, during rhinoplasty surgery to support the tip and keep it secured where I want it to stay.

I would advise you to consult with some revision rhinoplasty experts in your area so that you can be evaluated fully. Hopefully, it's a straightforward correction for you...

All the best,

Dr. Mehta

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Droopy tip following rhinoplasty.

I am sorry thINgs may be deteriorating following your revision.  At this point it is best to wait until 9 to 12 months pass from the date of your last surgery and then, if the result is unacceptable, seek out opinions for a possible third surgery.  Unfortunately I do not think that fillers are of much help in up rotating the nasal tip.

Mario J. Imola, MD, DDS, FRCSC.

Mario J. Imola, MD, DDS
Denver Facial Plastic Surgeon
4.8 out of 5 stars 116 reviews

Droopy tip

The best thing for you to do is to go for a consult to be re-evaluated for your nasal issues. Good luck.

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

Nose Tip Droopy After Second Surgery?

 Sorry to hear that your tip is still under-rotated.  No, in the next several months it's best for you to wait and see the final result.  Fillers to the tip can be done but will add volume, not make the tip appear upwardly rotated.  There is an isolated technique of trimming the anterior septal cartilage and placing a permanent suture to rotate the nasal tip upward if it's still under-rotated after 6 months.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Droopy Nasal Tip after Revision

All you can do at present is be patient and wait another 6 months to evaluate your result. At that time you can consider your alternatives which will be surgery or fillers that I do not like in the tip.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 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.