My nose has really started to droop especially when I smile. What treatment would you recommend? (photos)

The droop can be improved by treating the depressor septi muscles through the base of your nose or an incision on the inside of your upper lip--this latter approach would slightly lengthen your lip. You tip can be rotated slightly upwards as well.

Most people's nose droops when they smile. It only becomes a problem when the droop is excessive or when the tip starts off under rotated. Most people feel its the tip being pulled down by the depressor nasi muscle under the nose. This is true in some cases but in addition the cheek muscles also pull the sides of the nose up. This gives the appearance of the tip depressing. The depressor muscle can be cut, while the cheek muscle obviously can't.  Rhinoplasty can strengthen the tip by adding struts of cartilage behind the columella (the fleshy part below the nose and between the nostrils). The tip can also be rotated up and thereby reducing the overall degree of tip descent.

 A droopy tip is the consequence of weak tip support whereby the overactive depressor septi nasi muscle pulls the tip down. Commonly the choice technique is augmentation of  the tip support with application of a graft that is called a columella strut. Insertion of this graft usually disrupts the continuity of the muscle in addition to increasing the tip support. Although this muscle can be also be removed. For those who do not wish to have surgery injection of small amount of Botox can stop this muscle. However, this injection may result in slight elongation of the upper lip and minor change in the smile and the amount tooth show during smiling.

Hello,Thank you for your question and your photos. Tip depression, particularly when smiling is a very common complaint for patients that are undergoing rhinoplasty. You are correct that the depressor muscle can be divided during the procedure, but the most important component during rhinoplasty for patients that have tip depression is to create more support for the tip. The two techniques that we use are to either put a cartilage graft (a supporting strut in the tip), or to secure the soft tip cartilages to the strong border of the septum. This adds strength and support which will prevent the tip from pulling down.

Release of depressor muscle will solve your problen of droopy tip during smile.  Along with tip sharpening and little elevation of tip with columelar strut will make your  nose very good