Tip droops or is the columella? (photos)

I dont think there is an option to make the tip smaller? Not sure if it is my columella? My nose is long at certain angles. See pictures. One picture smiling on an angle my nose tip at the bottom goes down far and is long.

Doctor Answers 6

Tip droops or is the columella?

The tip and columella can be modified slightly as well as the muscle that is pulling the tip down during smiling.

Kenneth Hughes, MD

Los Angeles, CA

Rhinoplasty for droopy tip versus columella

 The photographs demonstrate an active depressor septi ligament which can be released at the time of the rhinoplasty surgery. The droopy tip can also be lifted with a tip rhinoplasty if necessary. The columella appears normal and is not hanging. For many examples of droopy tip repair, please see the  link and the video below.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Tip droops or is the columella?

Yes there are surgical options to help prevent tip drooping. Best to seek in person opinions and explanations... 

Frenulum and depressor

One interesting maneouver during rhinoplasty is cutting the muscle that connects the orbicularis muscle (around the lips, used to smile) with the nose; this muscle pulls down the nose in smiling gestures.

Alejandro Nogueira, MD
Spain Plastic Surgeon
5.0 out of 5 stars 34 reviews

Not your columella

Soccer24: Thanks for your question and photos.  I agree when you aren't smiling your nose on profile is attractive.  It is not uncommon for the tip to "droop" or get pulled down when smiling.  This is related to muscles that connect your upper lip to your nose, one of which is called the depressor nasi.  This muscle can be cut during a rhinoplasty which can help prevent the changes you are seeing when smiling.  One down side of cutting this muscle is that the upper lip can hang a little lower; thus, if you have really gummy smile, it can help that too, but if you have a normal smile (which you look to) it can reduce how much of the upper teeth are seen during smiling.  Your nose is a bit long but it is within the range of normal...if your height is on the shorter side (say 5 foot 6 or less) you could tolerate the tip of your nose being elevated a bit which will make your nose look shorter and may also help prevent it from drooping with smile.  If you are quite tall, it is hard to raise the tip because then people can "look into your nostrils."  Best of luck. 

Garrett Griffin, MD
Minneapolis Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Drooping Nasal Tip

In your case, plunging of the nasal tip upon smiling is caused by the depressor septi nasi muscles. The paired depressor nasi muscles extend from the upper lip to the base of the nasal tip. An active depressor septi muscle can cause drooping of the nasal tip and shortening of the upper lip on animation (smiling).  I think your photographs clearly show this action.  Your columella is quite normal, although your upper lip is a bit tethered (upward) by the muscles and ligaments that connect the upper lip to the base of the nose.  Both problems would be improved by either cutting or transposing the paired depressor nasi septi muscles. It is possible that you might also benefit from surgery to modify the tip cartilages and/or strengthen nasal tip support, however, specific recommendations could not be made without first examining your nose in person. I hope this helps. My Best.

Brock Ridenour, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 99 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.