Will releasing the depressor septi during rhinoplasty make my philtrum longer? (Photo)

Question

My nose is dynamic while smiling so I technically require this procedure but absolutely do not want to risk lengthening my philtrum. Thoughts? So the benefits outweigh the risk ?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Releasing the depressor nasi septi muscle will not elongate your philtrum. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon. If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Philip S. Schoenfeld, MD, FACS · Answer

Your question is a good one for a couple of reasons.  Many people present to me during rhinoplasty consultation who do tell me that they would like less activity of the tip of the nose when they are smiling.  Transecting the depressor septi muscle will help with this issue and should not result in lengthening the philtrum but your smile could be slightly different for a short period of time.  When I look at the frontal photos that you have provided I really do not see a great deal of change that your nose would likely require. Please be careful.  There are no guarantees in plastic surgery and changing one small dynamic aspect of your nose could result in changes to the static appearance of your nose which you may not desire.

Michael A. Carron, MD · Answer

Hi your question is a good one.  I perform this maneuver routinely as I have a LARGE patient population (mediterranean and middle eastern and eastern european) where this maneuver is a very important part of the operation to establish improved nasal base proportion and dynamics.  There is a temporary elongation but subsides in a month or two in all of my cases so far where this maneuver was performed.

William Portuese, MD · Answer

Releasing the depressor septi ligament only prevents the tip of the nose from drooping dynamically when smiling. It has no effect on the philtrum.

Will releasing the depressor septi during rhinoplasty make my philtrum longer? (Photo)

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