Address the “Hang-Down” Look in the New York Area
A nose that is often defined as a drooping nose at New York’s Williams Center is one where the tip of the nose hangs down. In some circumstances, it’s just a drooping tip, but in other circumstances, it’s complicated by a large profile or a bump on the nose, making the tip look considerably worse. For someone considering surgery for this anatomical variant, it is important to seek a consultation from a highly trained and experienced rhinoplasty specialist.
Patients can start by obtaining a consultation and communicating their goals to the doctor. Many rhinoplasty specialists do a great deal of listening first to understand what the patient’s goals and desires are during the consultation process. For example, some drooping nose patients only have cosmetic concerns to be addressed, whereby many patients with a drooping nose also have some sort of breathing difficulty on one side or another. Another important part of the consultation should include computerized imaging that allows the surgeon can alter the images, which functions as a wonderful communication tool between the doctor and the patient in the process of agreeing upon a desired goal or outcome.
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Reputable surgeons will not guarantee outcomes and are very careful not to show the drooping nose patient an image that they do not feel is achievable.
Fixing a drooping nose often consists of a couple of things. Many times, the tip of the nose needs to be rotated or brought upward slightly, as well as adding or rebuilding support to the tip of the nose so that it does not simply drop or fall again. With a drooping nose patient where there is a large contributing component that is a result of a prominent bump or dorsum, this should be addressed at the same time so that the patient is left with a very balanced approach, which can also make the nose fit the face better and look more natural*. The average patient who has a drooping tip will typically need to a stronger tip built, and this is done by harvesting cartilage from the nose. Think of it as recycling, as an experienced surgeon can take cartilage from areas in the nose where the cartilage is unnecessary and reorient them to another area to rebuild or regain support.
This and answers to many of the other questions that you may have can be found in the Frequently Asked Questions section of Dr. Edwin Williams‘ Famous Fireside Chats where he answers your questions about rhinoplasty.
Drooping Nose FAQs
Where Are the Incisions in Drooping Nose Rhinoplasty?
There are essentially two distinctive methods used in drooping nose surgery: the open and the closed approach. The closed or endonasal approach is often referred to as a “scarless” one, as it requires no incisions on the outside of the nose. The open approach does.
The advantage of the open approach is giving the surgeon a full view of the nose. Some doctors believe this lends itself to a more precise surgery. However, skilled and experienced surgeons often prefer the endonasal or closed approach, as it is creates less scarring and reduces healing time, which can alleviate discomfort for the patent. Also, in the closed approach to surgery, outcomes are easier to predict.
The closed approach does require an especially skilled and highly experienced surgeon, as it is more challenging to execute. In the first decade of his practice, Dr. Williams performed open-approach rhinoplasty until he gained the needed experience to move to the endonasal or closed surgery, which he now almost exclusively performs.
Drooping nose surgery is further explained in Dr. Williams’ Famous Fireside Chats series titled The Great Debate: Open vs. Closed Rhinoplasty.
Do You Pack the Nose after Drooping Nose Rhinoplasty?
In Dr. Williams’ expert opinion, if the nose is not in just the right position after a well-executed drooping nose surgery, heavy packing will not hold it in position. Instead, Dr. Williams uses the endonasal or scarless approach, which makes heavy packing unnecessary. Only a limited amount of dressing is used (think: small tampon), and it is removed the day after surgery.
The benefit of lighter dressing or packing of the nose is patients avoiding the most uncomfortable aspect of the drooping nose procedure. The week after surgery, Dr. Williams advises patients to avoid any work or other activity that could bump the nose for two weeks.
In Dr. Williams’ Famous Fireside Chats video, he demonstrates how the nose is dressed and the splint is removed (one week post op) after surgery.
Will Drooping Nose Surgery Fix Breathing Problems?
Many patients seeking to correct a drooping nose have difficulty breathing due to a deviated nasal septum, narrowing in the nasal valves, or an overall twisted or crooked nose.
Patients undergoing drooping nose surgery may also be experiencing breathing difficulties, which an expert surgeon can evaluate to determine if the problem can be fixed during rhinoplasty.
More information on this issue is given in Dr. Williams’ Famous Fireside Chats on correcting and fixing breathing during a drooping nose procedure.
The Cost of Drooping Nose Surgery
Fees for drooping nose surgery are set based on several factors. A revision (second or third) rhinoplasty, best done by a more experienced surgeon due to its complexity and the time needed to perform the procedure, will typically cost more.
Another factor is the surgeon’s physical location, as cost of living can contribute to costs.
And then there is the surgeon’s experience. While a practiced surgeon will charge more than a less experienced one, that experience improves the likelihood a satisfactory outcome.
The cost of drooping nose surgery typically ranges between $7,000 and $14,000, which reflects fees for the operating room and anesthesia. Refer to Dr. Williams’ Famous Fireside Chats regarding surgery fees.
Contact Lenses or Glasses Following Drooping Nose Surgery
Wearing eyewear after drooping nose corrective surgery can be a challenge. Since a splint or cast is often placed on the outside of the nose, Dr. Williams suggests that his patients tape the middle of their glasses to their forehead so the glasses hang down rather than rest on the nose.
Contact lenses should not be worn for a week or so after drooping nose surgery. Once the splint is removed, patients can go back to wearing their lenses.
How is Computerized Imaging Used in Drooping Nose Surgery?
In any rhinoplasty surgery, Dr. Williams starts with CGI—computer generated images—which he has used for some 25 years as a valuable and helpful communication tool. These images are useful in explaining to patients how the surgeon “sees” their nose and what is a realistic outcome of surgery.
Dr. Williams’ book Rhinoplasty: Everything You Need to Know about Fixing and Reshaping Your Nose addresses more questions related to surgery correcting a drooping nose, which are also discussed in his rhinoplasty Fireside Chats series available on our YouTube channel.
Complications and Risks of Drooping Nose Rhinoplasty
Complications from drooping nose surgery are quite rare when the procedure is executed by an experienced surgeon. Going over possible complications, which include bleeding and infection, is an essential part of any consultation by a practiced and respected surgeon.
Dr. Williams stresses that complications are rare in drooping nose surgery, but he lets his drooping nose surgery patients know that a small number of patients—about five to 10 percent, according to recent research—will statistically choose to have a touch-up procedure.
This percentage is significantly lowered if the surgery is performed by an experienced rhinoplasty surgeon. Drooping nose surgery is not an easily executed procedure. It requires a blend of ability, proficiency, and understanding of unique patient anatomy on the part of the surgeon.
With a clear-cut exchange of information between patient and surgeon concerning the potential outcome of drooping nose surgery, the patient can be happier, as more realistic expectations are met or exceeded.
More information on complications following drooping nose surgery surgery is available on Dr. Williams’ Famous Fireside Chats.
Anesthesia in Drooping Nose Rhinoplasty
Surgery correcting a drooping nose involves local anesthesia and twilight or general anesthesia, depending on the surgeon’s and patient’s preference. A well-credentialed and highly proficient anesthesia provider oversees its administration.
Outpatient anesthesia (local and/or twilight and general) in drooping nose surgery allows patients to recover at home after their procedure.
This aspect of drooping nose surgery is also clarified and further explained in Dr. Williams’ Famous Fireside Chat on Anesthesia for Rhinoplasty.