Does nose tip always drop after rhinoplasty?

• by Op. Dr. Evren Tevfik İşçi

• 1 September 2022

• 337

The nose is the most prominent element of the human face. For this reason, it is very important to have a beautiful and aesthetic nose for both men and women. One of the curiosity subjects of people who want to have rhinoplasty surgery is the question “Will my nose tip drop?” 

The situation that occurs due to the sliding of the tip of the nose from the surface of the nose back to a lower level, is called nasal drooping. Low nasal tip may cause narrowing of the angle between the nose and lips and cause an aesthetically unappealing appearance. It can also create an older and tired appearance than the person actually is. With the aging of people, there may be some downward displacement in the facial tissues and the tip of the nose, as is the case with all body tissues, due to the effect of gravity. In other words, as people get older, some drops can be seen at the tip of the nose. In cases such as thick nasal skin, weight changes and structurally low nasal tip, this decrease may be a little more. In such cases, it can be observed that the tip of the nose begins to fall at an earlier age. 

After the rhinoplasty surgery, the nose appears raised enough because the nasal tissues are hard. However, if the person’s age is under 40 and the skin is thin, there is not much shape change at the tip of the nose. If the person’s age is over 40, skin sagging has started to occur on the face, if the skin is thick and the nose is too large compared to the face before the surgery, a slight drop may be seen at the tip of the nose after the surgery. In order to prevent this, it may be possible to apply a method such as skin removal. However, it is not preferred by patients as it causes a line-shaped scar on the nose. However, in thick-skinned noses, techniques can be used to remove the skin from the upper part of the nose, transversely between the tip and the middle. Skin can also be taken from the nose wings or the lower point of the tip of the nose so that it remains in the suture line and it is not obvious that the skin has been removed. Although the skin intake is not very obvious in people with fatty thick skin and in elderly people, it can be uncomfortable because it appears as a line-shaped scar in young people. 

What to do to prevent the tip of the nose from falling?

The tip of the nose may be displaced after the surgery due to the insufficient tension and stiffness of the tissues. Although this is an extremely rare condition, it can occur mostly after nasal aesthetics performed on elderly people, in people with fatty and thick skin, and in people with a very large nose compared to their face. In rhinoplasty surgeries, physicians may prefer to make the tip of the nose slightly upturned than the target, since the tip of the nose will fall a little over the years. In this way, they try to ensure that the fall ends in the normal position. This amount of fall may also vary depending on the technique applied during rhinoplasty surgery. 

Especially in patients with a thick skin structure, the prominence of the tip of the nose decreases and a downward appearance may occur, since just behind the tip of the nose swells. It can also be expressed as a relative fall caused by the swelling of the supratype region, which is located just behind the tip of the nose in patients with thick skin structure and where the nasal skin is the thickest. Swelling just behind the tip of the nose may cause a decrease in the prominence of the tip of the nose, resulting in a downward image. This is a common condition in the first 6 months following rhinoplasty in patients with thick skin. Therefore, after rhinoplasty, patients with thick skin should wait patiently for at least 2 years, and patients with thin and normal skin should wait patiently for at least 1 year. This situation disappears completely, especially in the second year, and the tip of the nose becomes more lifted and more pleasant.

Dropping of the tip of the nose may also develop due to the inadequacy of the skeleton holding the tip of the nose or the excessive load pressing on the tip of the nose. In noses with a thick skin structure, the skeleton carrying the tip of the nose should be stronger because the load pressing on the tip of the nose is greater. Otherwise, a fall may occur at the tip of the nose. Therefore, in rhinoplasty surgery, the forces that push the tip of the nose down the back of the nose should be sufficiently reduced and relieved. Trying to lift it with a rope or other hangers without structurally changing it does not give long-term results and the tip of the nose does not remain at the desired level. The effect of lifting the tip of the nose with the filling is limited to the melting process of the filling. In addition, since the removal of the tip of the nose with filler is a procedure that enlarges the nose, it may adversely affect the quality of the skin in a possible rhinoplasty surgery to be performed in the future. 

Op. Dr. Evren Tevfik İşçi

Plastik cerrahi alanında ülkemizin prestijli eğitim kurumlarının başında gelen Hacettepe Üniversitesi Plastik Cerrahi Bölümü’nden uzmanlığını alan Evren Tevfik İşçi; samimi ve sıcak bir ortamda her hasta için kişinin ihtiyacına özel çözümler sunmaktadır.Op. Dr. Evren Tevfik İşçi’nin estetik ve plastik cerrahi kliniğinde; herhangi bir prosedürün başarısı için çok önemli olan açık iletişim üzerine güçlü bir doktor – hasta ilişkisi kurulur.

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