As I mentioned in my previous article, a drooping nose may occur due to various reasons. If, after surgery, your nose tip is not in the position you want, what can be done at that point varies depending on the reason why your nose drooped in the first place. Therefore, if you haven't read it yet, I suggest you take a look at the article "Will the tip of my nose droop after surgery?"

Firstly, if you are not satisfied with the result of the surgery, discuss it with your doctor. After all, you set out on a road, and your goal is to reach the end of it. In the vast majority of nose surgeries, the goal is achieved with a single operation, but even in the best clinics of the world and in the hands of the most experienced surgeons, there is a "revision" rate of 5-15%.

If the reason for a drooping nose is surgical deficiencies/errors, these must be corrected. In that case, your surgeon will or should explain to you in a clear, detailed and understandable way what is missing/wrong and what to do to correct it. Experienced surgeons do not hesitate to admit their own planning/application mistakes or the surgical deficiencies and share them with their patients. The key point here is to avoid vague plans and fuzzy explanations such as "We'll get it done", "a little touch-up", "a few stitches", "Let's open it and see". Because it is essential to be very clear about the causes and corrective strategies in revision surgery.

If a drooping nose is caused by the loss of height of the anterior angle of the central nasal cartilage, this lack of cartilage support should be corrected with the "septal extension graft" technique. If a drooping nose is due to the bending point that forms the dome of the nasal cartilages being too low, this bending point should be re-formed at a higher position. If the problem is that the nasal cartilages are structurally too weak to support the skin cover, the nasal tip cartilages should be strengthened with cartilage support grafts that we call "struts". If the cartilages are too long, they should be shortened. If the connective tissues holding the nose tip in place are not repaired, they should be repaired in revision, if possible. In brief, if the cause is surgery, the solution should also be surgery. A surgical mistake cannot be corrected by just waiting, by massaging or by applying some cream. On the other hand, considering surgical errors to be “unacceptable” is also a painful state of mind for patients.

One of the most important points when choosing a doctor for rhinoplasty is to make sure that the physician who performs the first surgery is also experienced in revisions, because you can then have the same doctor who knows the first surgery in detail and knows you as well and happily reach your goal at a much more reasonable price.

 

 

I previously mentioned that another reason for a drooping nose is false nasal tip droop (pseudoptosis). One of the most common causes of pseudoptosis is that the point where the nose tip and the nose ridge meet, that is, the "supratip" region in medical terminology, appears too high. In surgeries where the nasal skin is too thick, particularly in skeleton reduction surgeries, the skin and the connective tissue underneath may become loose in that region, thicken due to edema and make the nose tip appear droopy. This condition called soft tissue supratip deformity tends to resolve spontaneously, and recovery may take up to 2 years in some patients. In cases where the supratip deformity significantly impairs the appearance of the nose and it will be socially difficult to wait, we can speed up the process by injecting low-dose steroids into this area.

Another issue is the disagreements between the surgeon and the patient about the position of the nose tip. When you say, “I want an upturned nose because I want it to look that way in side view”, you should think about how the same nose will look in front view. When you look at a nose from the side, you may see a very pleasant curve, but the fact that nostrils are excessively exposed may disturb you. Unfortunately, social media photographs may not present a holistic view since you mostly see the patients from only one angle. There is a test we do with patients who say, “I wish my nose was a little more upturned”. We use a piece of transparent tape to suspend the nose tip on the forehead and thus lift it. When the patient says, “This is exactly the side view I want”, I ask them to look at the mirror in front view. At that point, most of my patients say “No, my nostrils are too exposed this time” and they give up. If the front view, that is, the visibility of the nostrils, does not bother my patient, I can raise the nose tip a little more with a minor revision.

As I mentioned in the previous article, in cases where it is “technically” not possible to make the nose tip more upturned, there is unfortunately no solution other than making peace with what you have.

Take good care of yourself and your beauty.