Nose tip droopy 3 1/2 months after primary rhinoplasty - skin is "ideal for rhinoplasty" (i.e. not too thick or thin) (Photo)

Question

I had primary rhinoplasty 3 1/2 months ago. Initially, the droopy tip had been fixed, even when smiling. About 1 1/2 months later my nose swelled up and the tip looked droopy. My Dr. gave me injections. Now a month after the injections she says it looks great, but as you can see in the pictures it's much more droopy than it was, especially when I smile. My question is, 1) is she lying? She has stopped responding to emails, and; 2) is it possible the droopiness is swelling or is it permanent?

Gerald Minniti, MD, FACS · Answer

Hello,Your nose definitely looks better than it did at one month. Your drooping tip is a fake out, and in fact the tip doesn't move. What is happening is the columella and ala retracting upwards with skin traction. Early in your post operative recovery, swelling prevented this from happening, by locking these structures in place under the tension of the skin pull while smiling. So this has nothing to do with any current swelling. Best of luck!

Michael Elam, MD (retired) · Answer

Dear hellokitty51, Injections in your tip are not going to help the "droopiness" in the tip so I would refrain from having any further injections. I would suggest seeking a secondary opinion aided with your original operative note and pre-operative photographs. It is irrelevant if the surgeon thinks your nose looks great it is about the patients preferences and whether the outcome looks similar to the proposed desired result. A surgeon should never abandon a patient or not take their calls or emails. You need to work together as a team to help give you peace of mind and to keep an open line of communication between you and your surgeon. You still have swelling that is temporary as you are three to four months post surgery and it takes a full year for all of the swelling to dissipate however this will not improve the droopiness of the tip. Best regards, Michael V. Elam, M.D.

Richard W. Fleming, MD (retired) · Answer

Careful observation of your tip over the next 6 months is the only way to answer your question. If it's any consolation a minor revision to lift your tip and hanging columella can be done to achieve the desired result.

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