Rhinoplasty: Cutting Upper Lip Muscle

There are many tiny muscles that can alter the shape of the nose and upper lip, especially during animation (i.e. when talking, laughing, or smiling.) There's one pesky muscle in particular, the "depressor septi nasi," that may need to be weakened, moved, or cut during rhinoplasty surgery.  "An active depressor septi muscle can accentuate a drooping nasal tip and shorten the upper lip on animation," concludes one important study published in 2000. This basically means that when smiling or laughing, the tip of the nose is pulled downwards, curving the nose like a bird's beak, and at the same time the upper lip can be pulled upwards giving a gummy smile. Cutting the muscle reduces or eliminates these undesirable distortions of the nose and lip. It is true that good tip support is always important to maintain tip shape and projection; however an overactive depressor muscle can still pull it downwards. Not everyone needs to have it cut or moved, but a good (board certified) plastic surgeon will be able to decide if this will help you!

Occasionally the depressor needs to be released to correct some abnormalities about the tip, but it is by no means done routinely, as you have noted a well done tip and tip grafting when appropriate are more important.

I cut the depressor muscles of the nasal tip when i get a history of the tip drooping when the patient smiles. however, this should not be done unless tip support has been treated.