I want to reduce the droopy tip and make it even. What can I do about my nose? (Photos)

Hello Brooke and thank you for your question.

Although an exam in person is ideal, from your photographs alone it appears that you can benefit from a subtle profile reduction and a tip rhinoplasty where the nasal tip cartilage is modified for a more refined, feminine look. The tip droop would specifically be addressed with extended spreader grafts locked into a columellar strut graft, further reinforced with nasal tip deprojection. The modification of your nasal cartilage can be done with trimming, stitching or grafting. If your septum is deviated and you have breathing difficulty, a septoplasty may benefit you as well -- insurance can cover this and reduce the price of your surgery☝️

The next step for you is to find the right aesthetic plastic surgeon. In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course. Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon. It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to my link below.

Good luck and please let me know if I can help.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon in Boston and Miami

Based on your photos, you are a great candidate for rhinoplasty. You can certainly do a tip only rhinoplasty, but I think your best result would involve the bridge as well. The procedure is usually done under general anesthesia. Be sure to see a rhinoplasty expert for consultation that can do computer imaging at the same time.

Rhinoplasty is a procedure best performed under general anesthesia. Patients who are young and healthy, like yourself as well as patients under 65 with good laboratory results typically do extremely well. Because we are operating on part of the airway, having an anesthetist protect and manage your airway is a significant benefit. Please note that this surgery is not considered a long procedure under general anesthesia; the estimated duration is approximately 3 - 4 hours.
A rhinoplasty would be an excellent option for enhancing your aesthetic appearance. It would soften and harmonize your facial features. I agree that supporting the tip of your nose and refining the tip and the angle of the bridge from its current rounded shape to a straighter or slightly more defined contour would open and balance your midface. This allows features such as your eyes, cheeks, and lips to stand out even more beautifully than they already.

The two cartilages that form the tip are responsible for holding the tip *down*, making the nose look long-ish, making the tip look droopy. Those cartilages also form the mass of the tip, and the tip looks wide and bulbous to me. Work on those tip cartilages would address narrowing the tip and elevating the tip.
How *much* to elevate the tip, or narrow the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs -- really, any time complicated tip work is done -- require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery.

Thank you for the photos and your question.I frequency see this in my practice. Based on your photos you need a rhinoplasty to refine your nasal tip and increase tip rotation. The overall straightness of your nose is hard to tell from the photos and I would need to see a full frontal view. This is done under general anesthesia or in some cases IV sedation. I recommend an in person consultation with a facial plastic surgeon or plastic surgeon who specializes in rhinoplasty. Best of luck!

Thanks for sharing your photos and concerns. While the angles make it difficult to give a specific recommendation, you do appear to be a strong candidate for rhinoplasty which is typically performed under general anesthesia. Techniques to refine and rotate the tip can make a meaningful difference. Since a few of your photos show you smiling or making an expression, it’s worth mentioning that techniques such as addressing the depressor septi muscle can help prevent the tip from being pulled downward when you smile if that is a concern.

I’d recommend consulting with a surgeon who has extensive experience in rhinoplasty. Choosing an office that offers photo simulation can also be helpful, as it allows you to preview potential refinements and better understand what aligns with your goals.

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. With good surgical technique, you could have an outstanding result. This should be done under general anesthesia for the best and safest results. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

The tip can be lifted with a tip plasty and a graft in the tip. However symmetry is very difficult to achieve. A TLC (Trans Labial Columellar ) tip lift can help. It involves a large graft of cartilage placed into the tip from under the upper lip. It can be done under local only.
Regards
Dr. Janjua

Thank you for your question. You are an excellent candidate for rhinoplasty, but do not think just the tip-plasty would be sufficient. I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.