Is There a Way to Do a Rhinoplasty on a Drooping Nose (Esp when Smiling) Without Lengthening the Upper Lip?

Is cutting the muscle (causing the upper lip to lengthen) the only way to fix a "drooping" nose?

Doctor Answers 15

Rhinoplasty for droopy tip

The most effective way to address a droopy tip is not by cutting the muscle but by cartilage grafting and tip suturing techniques which in fact can shorten the upper lip

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Nasal tip

An easy option to keep the upper lip still while smiling is to clip a band like muscle, at the roof of the upper lip.  This does not change the length at rest it just will not shorten when smiling.  It is a minor procedure with little down time.  Think  about getting an office visit with a plastic surgeon in your area for more information.

Rodger Wade Pielet, MD (in memoriam)
Chicago Plastic Surgeon
5.0 out of 5 stars 2 reviews

Worried about lengthening upper lip during Rhinoplasty

It's a matter of semantics.  When the tip is rotated up, the space between the upper lip and nose appears longer because it is no longer hidden by the droopy (rotated downward) nasal tip. 

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

Correction of a drooping tip in rhinoplasty

When the tip is rotated and elevated in a rhinoplasty procedure the upper lip is not lengthened to any degree. As far as cutting a depressor muscle, this is the 'weakest' maneuver and has the least impact on tip position and shape, and is seldom done. The lip can look longer as the shadow cast by the drooping tip is lessened, but the size will not change.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

The upper lip lengthens after the caudal septum is treated

The reason that upper lips lengthen after rhinoplasty is that the surgeon has changed the septum behind the columella--the so called caudal septum.  Even patients who have saddled noses from septal fractures have upper lip lengthening, regardless of what their noses looked like before the injury, because the septum has been broken.

Surgeons have tried to treat a pulled upper lip by cutting the muscle, but I never do that and can correct the deformity by trimming the caudal septum.  However, another associated problem is a weak, "inadequately projecting" tip, which manifests by the tip pulling down with smiling.  This is a tip strength problem, not an upper lip problem.

Find an experienced surgeon who can separate the issues for you.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon
4.5 out of 5 stars 25 reviews

Rhinoplasty to correct drooping nose w/o lengthening upper lip

During a rhinoplasty a drooping nose is elevated by removing excess cartilage from the nasal tip and bridge. Sometimes a droopy tip is supported with columellar struts.  If the tip plunges upon smiling, it is best treated by releasing the depressor septi muscle.  When lifting the tip upwards, it gives the illusion of lengthened upper lip.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Droopy nose

Droopy nose, especially when smiling (also called a tension tip) is fixed all the time without changing the length (or height) of the upper lip. Although optical illuson will suggest that the upper lip has lenghtened since you'll see more of it after the tip has been elevated and rotated upward.

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Correcting a Drooping Tip

Dear Texas,

It is possible to correct a drooping nasal tip without lengthening the upper lip.  "Lengthening" the upper lip may be an illusionary effect simply because more of the upper lip becomes visible when the tip is rotated upward, and may not be due to the depressor septi muscle being cut.  Good luck!

Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 47 reviews

Droopy nose

Rotating the tip often creates the illusion of lip lengthening as the area previously covered is more visible. How much you would like to see is something you can try and determine with your surgeon before the procedure. Very often the increased lip show is desirable, if you limit it you may continue to have some droop on smiling.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Droopy tip procedure

often times when tip projection is poor, a tip or columellar graft, or both, will correct the problem. cutting the nasalis septi muscle is for a "plunging" tip during wide smiling. it may not be necessary.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

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.