Why has my tip dropped so much after my rhinoplasty?

Question

It's at the 7th month point and my tip has dropped more than I wanted. I liked my tip when the cast first came off. My nose had intentionally been long, and had a hump ( which my doctor corrected ) however now.. I feel like my tip is bigger than I wanted it to look, I'm almost certain that my nose will not get smaller Is there maybe something a doctor could inject to make the tip go up? I really would appreciate the advice and to know if this tip will go up again :(

Jonathan Kulbersh, MD · Answer

Like most issues after a rhinoplasty, there could be multiple reasons why your tip has dropped 7 months after your surgery.  Some possible causes are:1)  As swelling goes down in the nose the tip can come down2)  Poor support in the tip region.  If there was destabilzation of the nasal tip during the surgery without adding support, the tip may droopAt this time, I would discuss your concerns with your rhinoplasty surgeon.  This may be a good time to look at some before and after pictures to take an objective evaluation of your results.I hope this helps.

Michael T. Somenek, MD · Answer

It sounds like you have a few concerns regarding your nose. The nasal tip can frequently appear bigger in the postoperative healing phase due to prolonged swelling in that region. The nasal tip is the most common area to have persistent swelling and edema postoperatively after undergoing a rhinoplasty. Healing continues in your nose for up to a year and you will continue to see small changes happen throughout this time. In my practice, I will use a combination of steroid injections and taping to help reduce the swelling that can sometimes persist in the nasal tip. The skin thickness of the nose can affect how much and how long you have swelling postoperatively. The thicker the skin, the longer the swelling and edema will be present in the tip.Regarding your drooping tip, there are several reasons this can occur. One can be that there is not adequate support in the tip to maintain it's position. The other can be that your swelling is starting to subside and the tip position is changing slightly. I typically ask my patients to wait till the one year mark before considering any additional procedures on their nose because healing is still occurring during that time.I would encourage you to follow up with your plastic surgeon who did the rhinoplasty and share these concerns as they may be able to help you through the healing process. I hope this helps!

R. Stephen Mulholland, MD (retired) · Answer

Dear Why Has My Tip Drooped:

Reduction rhinoplasty involves many complex structural
manoeuvres to provide adequate support and aesthetic balance.  In reducing the bridge bump, bony work is
required internally to the bridge and reduction to the bump settles much
quicker than the tip does.  It may be
that the apparent droopy tip still has a significant amount of edema and during
resolution the tip itself and the appearance of the tip and position of the tip
will change.  However, if the tip is
underprojected at seven months, it usually means that there may have been
inadequate support of the nasal tip or the bridge of the nose was not brought
down far enough. I would definitely not
seek any secondary rhinoplasty procedure until you have allowed one full year
for complete resolution both of the bridge and the tip aesthetics.  It is quite common for the tip to look
bulbous at seven months and end up looking great at 12 months from resolution
of the edema.  Inadequately projected
tips rarely become adequately projected by one year, but in the interim, you
might consider a very judicious amount of soft tissue filler to provide the tip
elevation that you require.  This can be
quite dangerous and tip necrosis has been reported, so it is very important
that you see a nasal surgeon expert.

It is always wise at this point to seek the advice of your
surgeon. They are in a better position to assess what is occurring as they were
the ones that end up performing the surgical procedures.

Over time, or a secondary surgery, I’m sure you will gain the
tip projection that you seek.  I hope
this information has been of some assistance.

For more information, please review the link below.

Sincerely,

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto

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