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Steven M. Denenberg, M.D.
Steven M. Denenberg, M.D.
rhinoplasty
 
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This young woman's nose appeared to sit too close to her face.  She had inadequate projection.  The goal of her operation was to bring the tip of her nose farther out from her face.

Her nose has some of the appearance of a cleft lip nose, but her lip is perfect: she was injured in a jungle gym accident.  The nose is reminiscent of a cleft lip nose because persons with that congenital deformity often have an associated deformity of the nasal tip cartilages that causes the tip of the nose to sit too close to the face.

The rhinoplasty surgery tutorial contains a chapter that discusses the importance of tip projection and how it is maintained or created surgically (the surgery tutorials contain explicit photographs taken during surgery).


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"...you will not find a more knowledgable,
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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: My nose is too narrow and I have droopy tip when smiling after rhinoplasty. Is this because of my smile muscle?
I had a septorhinoplasty done almost 2 years ago by a well certified doctor. The procedure was to correct my septum, straighten my nose, hump reduction and reduce a bulbous tip. Overall I feel my nose looks better but it seems that the tip is too narrow looking pointy and the tip droops when I smile. I feel this has gotten worse over time. My surgeon says its because of my smile muscle, is that true? Is this something a tip revision can correct?
(Questioner submitted photos)

Dr. Denenberg's answer: A contrarian viewpoint
Well, you didn't post any **non-smiling** views, but from the smiling view you submitted it seems to me that your nose is long, even without smiling. Everybody's nose tries to lengthen when smiling, but it doesn't lengthen *hugely*, and in order for the nose to not look too long when smiling, it needs to be shorter when the face is at rest. Perhaps if you posted profile views when not smiling, we would be better able to get this figured out.

I personally feel that it's just not possible that clipping a tiny muscle will fix this problem. In fact, it wouldn't fix anything at all. In another fact, I never clip that muscle, because I don't think it does anything. If we want a nose that is short enough, when smiling and when not, it takes advanced work on the tip cartilages, to get the tip to a good position, and sutures to hold the tip in place when the facial muscles try to pull it down with smiling.

Link to this question on RealSelf.com



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