Pointed nasal tip when smiling. Is there any way to make my tip not drop so much when I smile? (photos)

Question

Underwent revision rhinoplasty for drooping, sharp nasal tip when smiling. Surgeon insisted septum trim not necessary, he simply lifted the tip and trimmed columella. Now when I smile the nasal tip is sharp and pointy almost exactly as it was after initial surgery. My alar wings go up really high when I smile, which is why I think it must be a long septum causing such a prominent sagging nasal tip. Is there any way to make my tip not drop so much when I smile? It looks really masculine when I do

Jonathan Kulbersh, MD · Answer

Thank you for submitting your question and photos. It is possible for revision rhinoplasty to correct the sharp, pointy nasal tip you describe. A lack of support for the lower cartilage can sometimes cause the tip to fall or droop over time. 
By placing a columella strut between the lower cartilages, the nasal foundation can be properly supported and strengthened while improving symmetry. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can review your surgical history and suggest the best course of action for helping you reach your cosmetic goals moving forward.

Gurkan Kayabasoglu, MD · Answer

Hello. I think you are completely right, your doctor has made a wrong interpretation and application in this regard. The downward drooping nose tip is one of the findings that usually make people look old. It is possible to fix this. Do not worry at all, trust your surgeon. I’m the only triple board-certified facial plastic surgeon all around Europe. I’m just focused on this issue. I am a doctor who goes to almost every country in the world and explains my techniques to important doctors with the seminar invitations I receive, so I am definitely the only doctor who can perform your operation very comfortably and successfully. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile (+90 539 204 40 90). You can also book an online consultation and discuss your problems with me. With all respect.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hello there! The photos are very helpful that you provided. Drooping of the tip can result from a lack of support and strong smile muscles that pull down the tip. There are ways to fix this. Removing more cartilage makes the tip weaker and the columella “hang”. A strong, caudal septal extension graft made of cartilage would be used to reposition the tip via suturing and not allow it to drop. This structure approach to rhinoplasty is very powerful. Hope this helps!

William Portuese, MD · Answer

Much more information is needed, such as a full set of photographs from all angles and copies of your operative reports to find out what maneuvers were accomplished in the first two procedures. Revision rhinoplasty is much more difficult than a primary rhinoplasty. From the limited photographs, it appears that you have a hanging columella, a droopy tip, and an active depressor septi ligament. Make sure you wait at least one year before undergoing any revision work.

Pointed nasal tip when smiling. Is there any way to make my tip not drop so much when I smile? (photos)

Answers (4)

More Revision Rhinoplasty Questions

WE SEND PRETTY
EMAILS

Answers (4)

More Revision Rhinoplasty Questions

8 months post op and considering a revision rhinoplasty. One side is longer and nostrils are uneven. Options? (photos)

How to fix breathing problems after bad rhinoplasty?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS