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This young Virginia Beach woman was concerned about the hump on her nose and the position of her tip.  During our in-depth consultation, we discussed how rotating the tip up or shortening the nose would be just as important aesthetically as taking the hump down. She also expressed that she was bothered by her tip dropping when she smiled, and so we planned to use techniques that would decrease this tendency. I explained to her that there are two factors involved when the tip drops when smiling: one absolute and one relative. The first factor is the depressor septae, an upper lip muscle, which can physically pull the tip down on smile. The second factor is the tip seeming to drop when the smile muscles pull the cheek upward, making the tip of the nose appear to be lower.  Both of these issues can be improved upon by having the tip at a higher resting position, and the first issue can be mostly eliminated through techniques that prevent the tip dropping on smile.  Post-procedure, this patient is extremely pleased with the changes to her nose – we made the bridge straighter, but lowered it only to a natural position in order to avoid an “operated-on” look.  She is also happy with her tip, which we brought up to a much more youthful, feminine position.

Surgeon: Dr. Thomas Hubbard

Case Number: 462

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