Does the Tip of Your Nose drop After a Rhinoplasty?

I have made the decision to get my nose done and I'm in the process of finding a surgeon who's performed many rhinoplasties and has the experience I'm looking for. I have heard from friends that immediately following a rhinoplasty you can look a bit piggish, but if your rhinoplasty was performed correctly, the tip of your nose should drop, giving you a more natural appearance. Is this true? Thank you! 

NYJessica

F, 27, New York

The tip should not drop too much after rhinoplasty, as long as your surgeon takes measures to create nasal tip support. However, it’s very important that your surgeon also plans for a strong profile with a slight curve just above the tip. This transition is important to create proper tip definition and an overall natural look.

Note that a number of subtle changes will take place starting after the first month of your rhinoplasty procedure. These should continue for approximately one year. After the one-year mark, once the swelling has completely gone away, your nose will not experience any further changes.

The “piggish” look you refer to is often the result of postoperative swelling. Until the swelling subsides, which can take up to a year, the nose may have a slightly upturned, bulbous tip that creates this effect. And once the swelling does subside, it may make the nasal tip look like it has dropped.

However, the nasal tip does drop, albeit gradually, as part of the aging process. It is very important that your rhinoplasty surgeon constructs a sturdy nasal framework to account for this natural process. If the surgeon fails to do so the result may be a “pinched” or “shrink-wrapped” looking nose.

An experienced surgeon will anticipate the changes that take place over time so that your nose endures the passage of time.

An experienced facial plastic surgeon should be able to avoid creating a piggish look, and your nose should not drop significantly. In fact, if the nose drops a lot it may be a result of an error made during surgery.

There are a few reasons the nose might drop after nose reshaping surgery. One reason is that the surgeon failed to plan for the drop when designing the tip support. Experienced nasal surgeons know that the nose naturally contracts downward as a result of the incisions contracting; and that this, along with the natural effect of gravity, can cause the tip to drop. The surgeon needs to anticipate this and plan for it prior to the nose surgery.

A second reason the nose tip might drop is if the tip cartilage that remains after surgery is not strong enough to hold the nose up. If the surgeon fails to realize that the tip cartilages are weak, the end result may be a droopy tip and unsatisfactory profile. The surgeon should assess this factor during the initial rhinoplasty consultation by feeling and examining the alar cartilages (lower lateral cartilages), other nasal cartilage, and nasal bones.

Another reason why a patient might complain that his or her nasal tip has “dropped” after a rhinoplasty is if the nasal tissue above the tip has elevated in such a way as to make the tip look like it has dropped. As swelling goes down and the nasal tissues begin to heal, the upper lateral cartilages (cartilages in the middle of the nose) start to rise up and move slightly towards the midline. If the surgeon fails to sufficiently trim these cartilages they will rise further than anticipated, in turn causing a profile convexity that makes the nasal tip appear as if it had dropped.

Rhinoplasty is one of the most complicated of all facial plastic surgery procedures. As such, it requires experience, skill and planning on the part of your surgeon. Unfortunately, not all practitioners offering rhinoplasty possess these necessary traits. When searching for a surgeon to perform your tip rhinoplasty or other cosmetic surgery, be sure to look for a board-certified plastic surgeon who specializes in nose procedures.

Dr. Alexander Ovchinsky has 10 Revision Rhinoplasty before & afters:

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Hi-

  Yes that is absolutely true. Swelling can cause your nose to look full and raised at the tip and once it resolves it becomes much more natural. Good Luck and congratulations on making the decision!