Droopy nose tip when smiling - Am I a good candidate for nose filler? (Photos)

Question

I want to make my tip less droopy when I smile.I like my nose at rest, but when smiling or laughing it gets quite large and widens as well

Raffy Karamanoukian, MD, FACS · Answer

Non-surgical options for cosmetic dermatology and plastic surgery continue to improve with time. Botox injections and Volume fillers continue to be at the forefront of cosmetic rejuvenation given their high safety profile and efficacy. Facial fillers are used to volumize areas of premature hollowness or wrinkling, whereas Botox is used to reduce hyperactive facial muscles around the eyes, forehead, and chin.

Understanding the various attributes of each filler and Botox option can be discussed in detail during your consultation in our Beverly Hills or Santa Monica offices. Rest assured that we will provide you with exceptional attention to detail and professionalism. 
Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photos and concerns. It’s very common for the nasal tip to appear droopier or wider when smiling, due to the way certain muscles pull on the nose during facial expressions. Many people notice this change, even if they are happy with their nose at rest.

Why Does the Nose Tip Drop When Smiling?
The main reason is the action of a muscle called the depressor septi nasi, which pulls the tip of the nose downward when you smile or laugh. This can make the tip look droopier and the nostrils appear wider.

Can Filler Help?
Nonsurgical rhinoplasty with hyaluronic acid filler can sometimes help improve the appearance of a droopy tip, but it has limitations:

Filler can be used to subtly lift the tip or camouflage minor irregularities.
It cannot stop the muscle movement that causes the tip to drop when you smile.
Overfilling the tip can make the nose look bulky or unnatural, especially in motion.
Other Options:

Botox: In some cases, a small amount of Botox can be injected to weaken the depressor septi nasi muscle, reducing the downward pull when you smile.
Surgical Rhinoplasty: For more significant or permanent correction, a surgical approach can address both the muscle and the nasal structure.
Are You a Good Candidate?
If you are happy with your nose at rest and only bothered by the tip movement when smiling, you may benefit from a combination of subtle filler and/or Botox. However, results are temporary and best suited for mild cases. A consultation with an experienced injector or facial plastic surgeon is important to assess your anatomy and discuss realistic expectations.

Summary:
Filler can provide a subtle lift to the nasal tip, but it won’t completely prevent the tip from dropping when you smile. For some patients, a combination of filler and Botox can help. For more dramatic or permanent results, surgery may be considered.

If you’d like a personalized assessment, I recommend an in-person or virtual consultation with a board-certified provider experienced in nonsurgical and surgical rhinoplasty.

Steven M. Denenberg, MD · Answer

Almost everyone's nose dips down when they smile. It's not possible to change the nose so that it doesn't do that. When someone is bothered by the length of the nose when smiling, it's almost always the case that they think their nose at rest is at least a little too long. So we shorten the nose, so it's shorter at rest, and then when the smile tries to pull the nose down, the nose can't get as long with the smile as it did before surgery. Also, after surgery, some of the sutures that we place on the inside of the nose help to keep the nose more in place with a smile.

I like to make high quality morphs for my patients, to show what the nose might look like after surgery -- that helps them understand and fine-tune what the goal would be.

I like to make high quality morphs for my patients, to show what the nose might look like after surgery -- that helps them understand and fine-tune what the goal would be.

Nelson Lee Novick, MD · Answer

For a droopy nasal tip consider a couple of microdroplets of Botox along with the a medium viscosity HA filler injected appropriately at the base of the columella and at the tip of the nose. Injecting the nose is not an area for novice, inexperienced injectors. So, you would be wise to consult an experienced, board certified cosmetic dermatologist injection expert. Hope this helps and best of luck.

Ronald J. Edelson, MD · Answer

Nose filler will
Not work in your case. However you are a good candidate for a surgical rhinoplasty which would include raising the tip

Erik Peterson, MD · Answer

A droopy nasal tip that appears mainly when smiling is usually caused by muscle movement, not a structural problem with the nose.
In those cases, Botox, not filler, is typically the best treatment. A small amount of Botox placed into the depressor septi nasi muscle can limit how much the tip pulls downward when you smile, helping the nose look more lifted and less dynamic without changing how it looks at rest.
Nose filler is generally not the right solution for this concern. Filler adds volume and is better for camouflaging bumps or smoothing contour irregularities. In someone who already likes their nose at rest and feels it looks larger when smiling, filler could actually make the nose appear wider or heavier.
If the drooping is severe or related to nasal structure, surgical options may be discussed, but for many patients with smile-related tip drop, Botox alone works very well.
An in-person evaluation is important to confirm the cause and make sure treatment is safe and appropriate.

Citrus Aesthetics - San Diego · Answer

This is a very common concern, and you’re asking the right question. When the nasal tip appears droopy or widens specifically when smiling or laughing&mdash;but looks balanced at rest, it’s often due to dynamic muscle movement rather than the structure of the nose itself. In many cases, the depressor septi nasi muscle pulls the tip downward during animation.
Because of this, nose filler alone is not always the best first solution. While filler can be helpful in certain noses to support structure or improve balance, adding volume to a nose that already looks great at rest may unintentionally make it appear larger when smiling.
This is where a multi-modality approach becomes essential. For many patients, carefully placed neuromodulator (such as Botox) to relax the muscle responsible for pulling the tip downward, sometimes called a “Tinkerbell Lift”, combined with very conservative filler in select areas, can create a more refined, natural result that preserves what you already love about your nose but also addresses your goals of lifting the tip.
A proper assessment includes evaluating:
- Your nose at rest and in motion- Muscle activity when smiling- Facial proportions and balance- Skin thickness and nasal anatomy
The goal is never to overfill, but to treat the underlying cause while maintaining harmony with the rest of your face. An in-person consultation is critical to determine which combination of treatments, if any, is appropriate for you.
Aesthetic treatments should always be discussed with and performed by a trained, licensed, and medically certified aesthetic provider. The recommendations above are for educational purposes only and do not replace an in-person consultation, examination, or personalized medical advice.

Droopy nose tip when smiling - Am I a good candidate for nose filler? (Photos)

Answers (7)

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