Why the nasal tip droops and spreads when smiling after rhinoplasty: foreign material removal and tip correction methods

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited our clinic concerned about a drooping nasal tip and a pinched look.

• 7 years ago: Nasal filler injection

• 7 years ago: Silicone implant + additional material (exact material unknown)

• Disliked the nasal tip spreading when smiling

• Wanted a refined look

• Wished for the nasal tip to be slightly elevated

• Wanted to improve the drooping appearance

• Desired a look that was both natural and defined

The key focus of this surgery was to correct the drooping tip and pinched look while creating a natural yet defined nasal contour.

1. Foreign material removal and tissue evaluation

• Complete removal of the nasal filler injected 7 years ago

• Removal of the preexisting silicone implant

• Detailed evaluation of the remaining cartilage

• Establishment of a revision rhinoplasty plan with safety in mind

2. Creating natural height through revision rhinoplasty

• Natural correction of the drooping nasal tip

• Correction of the pinched appearance

• A refined and defined line

• Securing stable support for the nasal tip

3. Nasal tip improvement

• Correction of the nasal tip spreading when smiling

• A subtly elevated, natural nasal tip

• A soft and well-defined tip shape

• Improvement in overall balance

4. Correction of nasolabial angle

• An appropriate angle correcting the drooping look

• A defined yet natural profile line

• An elegant profile silhouette

• A refined overall impression

Front view changes:

• Natural improvement of the drooping nasal tip

• Correction of the pinched appearance

• Improvement of tip spreading when smiling

• Enhancing overall facial balance

• A refined and defined frontal line

Profile view changes:

• Natural improvement with the drooping nasal tip subtly elevated

• A defined profile line through nasolabial angle correction

• A soft, neat nasal tip line

• A refined profile silhouette

• A natural yet defined impression

Nostril view changes:

• Improvement in nasal tip shape

• Achieving bilateral balance

• Alignment of the columellar midline

• Natural nostril shape

• Improving overall symmetry

A drooping nasal tip and a pinched look are not simply aesthetic problems. They represent a complex issue requiring comprehensive consideration of cartilage support, skin thickness, and overall facial balance.

In this case, as time passed after the prior procedures, the nasal tip began to droop and appear pinched. In particular, the nasal tip spreading when smiling indicated that cartilage support had weakened. To address this, we developed a systematic revision plan.

First, we removed the filler injected 7 years ago and the silicone implant, then thoroughly evaluated the condition of the remaining cartilage. After assessing the cartilage, we focused on correcting the drooping tip while building a natural height.

A particularly important consideration in this surgery was creating an impression that was both natural and defined. We made meticulous adjustments to achieve a subtly elevated, moderate angle for the tip and a refined line that did not look artificial.

Through nasolabial angle correction, the drooping appearance was resolved, resulting in a well-defined profile line. The spreading of the tip when smiling was also stably corrected by strengthening cartilage support. As a result, we naturally achieved the refined, defined look the patient wanted.

Revision rhinoplasty is far more complex and challenging than primary rhinoplasty. However, through an accurate diagnosis, systematic planning, and precise surgical technique, we were able to deliver the natural and defined result the patient desired.

I will continue to provide customized surgeries that reflect each patient's individuality and requests through this meticulous approach. I hope this helps those with similar concerns.

This was Dr. Peter C. Kang. Thank you.

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