Does Drooping Occur After Rhinoplasty?

Nasal tip ptosis can be defined as the downward displacement of the nasal tip, where the tip of the nose moves below the level of the nasal dorsum (the upper part of the nose). This condition results in a reduced nasolabial angle (the angle between the nose tip and the upper lip), which can create an undesirable and unnatural appearance for the patient.

In Istanbul, whether nasal tip ptosis occurs after rhinoplasty depends on various factors, so a definitive answer cannot be provided. Nasal tip ptosis can be due to the natural structure of the nose, or it can result from excessive tissue removal, lack of experience, or overly aggressive surgical intervention during rhinoplasty.

One of the main causes of nasal tip ptosis post-rhinoplasty is the removal of an excessive amount of cartilage and bone from the nose. Therefore, it is crucial to carefully choose a skilled rhinoplasty surgeon before undergoing surgery. If this choice is not made wisely, the patient may experience nasal tip ptosis after surgery, necessitating a second rhinoplasty.

In an ideal and aesthetically pleasing nose, the nasal tip should be positioned at a right angle (90 degrees) to the upper lip. When nasal tip ptosis occurs, this angle decreases, bringing the nasal tip closer to the lip. This condition is often noticeable to others and can lead to negative social experiences and reduced self-confidence for the individual.

As mentioned earlier, meticulous planning is essential in rhinoplasty to prevent nasal tip ptosis. Effective communication between the patient and the surgeon before the procedure is important. The patient should clearly express all concerns and expectations, and the surgeon should design a plan that appropriately considers the patient’s existing bone and cartilage structure. Utilizing advanced technology to visually demonstrate the planned procedures and outcomes, and planning with facial type and bone structure in mind, is crucial. Overpromising by the surgeon can adversely affect the patient’s psychological well-being after surgery.

For individuals with nasal tip ptosis, a secondary rhinoplasty can be performed to correct this condition. In such cases, the cartilage in the nasal tip can be reshaped, with reduction or re-angulation as needed to achieve the desired result. Supporting the cartilage and using techniques such as nasal tip suspension are necessary steps to elevate the drooping nasal tip.

If nasal tip ptosis occurs as a result of rhinoplasty, it is generally recommended to wait 10-12 months before undergoing a second surgery to allow the new shape to stabilize and for swelling and edema to subside. After this period, the patient should consult with their rhinoplasty surgeon to discuss their concerns. The technique used to correct the nasal tip ptosis may vary depending on the situation, but since it is performed under general anesthesia, the patient is not expected to experience pain or discomfort.

How is A Second Surgery For Nasal Tip Ptosis Performed?

If nasal tip ptosis occurs due to the over-removal of bone and cartilage during the initial rhinoplasty, a second surgery using an open technique may be necessary. In this second surgery, cartilage is harvested from the ear or rib and placed in the nose to support and reshape it. As with the first rhinoplasty, it is important to avoid trauma or injury to the nose, adhere to the medication regimen prescribed by the rhinoplasty surgeon, and rest extensively, especially during the first week post-surgery.

While nasal tip ptosis after rhinoplasty is a common issue, patients should carefully choose their rhinoplasty surgeon and understand that this problem can be corrected if it occurs.