Can my nose be made thinner with tip plasty? I am concerned w/ my nose appearing wide and tip drooping down when I smile.(photo)

I have had silicone injected in my nasal bridge many years back to lessen the appearance of my dorsal hump which still slightly shows. My main concern is the droopy nasal tip and wide/thick nose appearance when I smile. My nose looks slim when I'm not smiling but it seems to take a rather triangular shape and droopy tip when I cheese and I am quite unhappy with it.

Doctor Answers 9

Nasal tip falling

Your nasal tip is falling is because you have no tip support. One of the major concerns in rhinoplasty is to always provide tip support. You only had filler put in the bridge of your nose and as your tip continues to fall as you age, the bridge will look higher. You will ultimately need a columella strut.


Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 48 reviews

Rhinoplasty will make a nice improvement...

From your pictures, you appear to be a great candidate for rhinoplasty. During the procedure the tip can be lifted and the cartilage supported so it doesn't droop and widen when you smile. Best of all, the result should look totally natural if properly done by a qualified rhinoplasty specialist.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 188 reviews

A droopy tip while smiling

A smile along with the movement of the lip pulled down the nasal tip making the tip appeared droopy.  This can be improved with rhinoplasty that reduces the slight dorsal hump, upturns the tip by cephalic trim and reduces the pull on the tip from the lip by cutting the muscle between the two called depressor septi.

Regards

Dr. J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

Rhinoplasty

Thank you for your question.  Based on your pictures, I think you would benefit from an open rhinoplasty to decrease your dorsal hump, elevate your tip and osteotomies as well to narrow your bridge.  Best to speak to a board certified plastic surgeon for a full evaluation.  All the best, 

Keshav Magge, MD
Bethesda Plastic Surgeon
5.0 out of 5 stars 29 reviews

Full rhinoplasty for dorsal hump and droopy tip reduction

 The photographs demonstrate a large dorsal hump, a droopy tip, and a wide nasal bridge. A full rhinoplasty is required to shave down the cartilaginous dorsal hump, lift the tip and balance all the nasal components with themselves. It's also important to release the depressor septi ligament which pulls the tip downwards when smiling. Silicone injections in the nose make the  procedure more difficult, so choose a rhinoplasty surgeon based on extensive experience

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

Rhinoplasty

A rhinoplasty would help to reduce your dorsum and elevate your tip. Best to be seen in person to be properly evaluated.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Nasal harmony

Your nose has a small hump and a droopy tip, which is worse when you smile. This combination of a hump and a dynamic droopy tip shows up very regularly in my practice. The best approach to the nose is to take the hump down in a controlled fashion and support the tip. Occasionally, the nasal bones need to be brought toward midline when the hump is taken down to prevent the nose from looking too wide.

In your case, you would benefit from a subtle reduction of the hump and an open rhinoseptoplasty with a tongue-in-groove to support the tip. It would be a very rapid recovery with a beautiful, lasting, natural result.  Likely could be performed without breaking the bones.

Best of luck from Manhattan.

Benjamin C. Paul, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

Supporting the dependent nasal tip

Thank you for the question and photos.  Firstly, I would discourage any future use of injected silicone oils.  Problems arising from injected silicone oil are often devastating not amenable to treatment.  Your photos show a dorsal hump with dorsal convexity.  Furthermore, your tip plunges dynamically on smile.  This is also referred to as a dependent tip relying on the angle of the septum for support.   Lowering the dorsal hump without providing independent support to the tip may inadvertently worsen the plunging tip by severing the existing support from the septal angle.  Based on your photos, I would plan your surgery to lower and straighten the nasal dorsum while simultaneously provide tip support.  Tip support can be provided by way of a cartilagenous strut graft or reestablishing septal support with suspension sutures from the medial crura to septum.  With meticulous surgical planning and execution, I believe you are an excellent setup for an aesthetically pleasing outcome.

Chen Lee, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 17 reviews

Nasal tip

The condition that you have is called "tension nose" and is characterized by an overgrowth of the nasal septum that puts into tension the rest of the structures, it also "pushes" the nasal tip down particularly when you smile. Correction of the condition with rhinoplasty will rotate the tip up to look more feminine. Tip narrowing can be done at the same time. 

Vartan Mardirossian, MD
Jupiter Facial Plastic Surgeon
4.7 out of 5 stars 33 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.