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15 years post rhinoplasty & unhappy with droopy tip, recommendations? (Photos)

waterbottlerMar 6, 2022
...possibly because of hanging columella? I had my depressor septi cut because pre op I actually had a droopy tip when smiling. But for years and years it’s bothered me that my nose feels bulbous and my nostrils pull upward when I smile. Would I be a candidate for revision? I was happy with the result shortly post op but when I compare those pictures to not long after, my tip definition almost faded and the columella looked more droopy. I hate how my nose turns white when I smile, it looks like it pains me to smile.

Answers (2)

From board-certified doctors and trusted medical professionals
Dr. Barry M. Weintraub, MD, FACS
Board Certified Plastic Surgeon
Answered on Mar 17, 2022
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Dr. William Portuese, MD
Board Certified Facial Plastic Surgeon
Answered on Mar 7, 2022
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Edwin F. Williams, III, MD

Thank you for your question. Notched ala is a complication of rhinoplasty that can sometimes be seen. There are techniques to improve the appearance and lower the ala to a more natural position using composite grafting from the ear. I recommend consultation with a board-certified facial plastic...

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Nima Shemirani, MD

Hi @Alberto31! I recommend seeing an expert revision rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination. Best of luck, Dr. Nima!

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Eric M. Joseph, MD

Not really - You have a deep indent between your tip and bridge, and an issue like this may be best addressed with a permanent non-surgical nose job treatment to permanently fill the indentation. If your breathing is fine, you may not need additional surgery. Hope this helps. Dr Joseph

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Richard Mark Winters, MD

Your plunging tip is the consequence of poor support… the likely solution to this issue is a septal extension graft which (at least in my hands) is most accurately placed by way of an open approach.. Good luck…

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Jeffrey H. Spiegel, MD

Usually this is quite possible, but it will depend upon how much scarring you have and how much skin you have (or skin contraction). If you had a hook before, it is likely doable. We would do a cartilage graft to extend the nose down.

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Eric M. Joseph, MD

Your candidacy for revision rhinoplasty will require an examination. Repair of your poly-beak, adding tip projection on profile, and an attempt at improving nasal symmetry may be considered. You may need cartilage grafting to reconstruct and support your droopy tip, and this is best performed...

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