How would you fix my drooping nose tip after primary rhinoplasty? (Photo)

Question

I feel like my nose tip looks fuller and lower, and my nostrils more snarled after my primary. It’s nearly been 1 year. Is this correctable in revision rhinoplasty and if so, what manoeuvres would need to be done? Is it worth it?

Thomas A. Mustoe, MD, FACS · Answer

Although the photos are limited and don’t show your profile your nose overall looks nice but I do agree your tip could be lifted slightly.  If this is all that you desire that could be done as a relatively minor office procedure without having to do an extensive procedure, but an in person examination would be necessary. Remember that a wide smile always pulls down the tip and makes the nose appear wider.

Russell Kridel, MD · Answer

When assessing your nasal tip, it is important to understand the effects of your facial expression and nasal tip position. Some patient have a “smiling deformity” in which the nasal tips droops due to action of the depressor septi nasii muscle. It is possible to have this muscle weakened or resected during rhinoplasty or during a minor nasal procedure. It is also important to recognize that with smiling, some patients have movement of the nasal alae (the “wings” of cartilage on either side of your nasal tip) superiorly, which may give the illusion of droopy nasal tip. In both photos you provided, you are smiling. You should assess your nasal tip position with a neutral expression. The profile view is also the best view to assess a droopy nasal tip.
  
Furthermore, it is possible you have a droopy tip not associated with smiling. In this case, there are multiple surgical maneuvers that can correct a droopy nasal tip. I have published several articles regarding correction of a droopy tip. An example is a lateral crural overlay technique. I have provided the article for your reference. Your surgeon can determine the best maneuver to correct your droopy nasal tip after an examination and complete assessment of your nasal tip position in multiple views.

William Portuese, MD · Answer

The nose is a three-dimensional structure, and rhinoplasty is performed in all three dimensions, therefore a full set of facial photographs  from all angles are required to make a determination about how best to proceed.  Revision rhinoplasty is more difficult  than a primary rhinoplasty, so  an in-person examination will be required.

Jordan Rihani, MD · Answer

It is hard to tell from the photos whether you have a drooping tip or just some infratip lobule fullness. Causes of infratip lobule fullness could include swelling or excess cartilage from the septum or lower lateral cartilages. An in person evaluation would definitely be helpful to determine whether this could be corrected with some simple maneuvers or whether you would need a full revision procedure.

How would you fix my drooping nose tip after primary rhinoplasty? (Photo)

Answers (4)

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