Опущение кончика носа: причины и решения

Опущение носа происходит, когда кончик носа опускается ниже спинки носа и приближается к губе. Предотвращение опущения кончика носа, особенно при мясистых носах, возможно с помощью современных техник ринопластики.
 In the past, nasal cosmetic surgery techniques were based on reducing the size of the nose. Surgeons would shave down the nasal bones and cartilages to make the nose smaller, and they would give the excess bone and cartilage to the patient in a jar containing alcohol!
With this method, the nose became smaller and the patient was satisfied. But that was not the end of the story. Several days to several months after surgery, during tissue healing, a phenomenon called fibrosis occurs, during which substances are produced that exert a pulling force on the nasal skeleton, causing the nose to change shape. The thicker the nasal skin, the greater the power of this process to deform the nose. Most of the changes occur at the nasal tip, causing it to be pulled downward.
 With that said, if the structural integrity of the nose, especially in the tip area, was compromised during surgery, the nasal tip would eventually descend and the nose would lose its beautiful appearance. In a beautiful nose, when viewing a person in profile, the nasal tip should be higher in women and level with the nasal bridge in men. But when the drooping phenomenon occurs, the nasal tip descends below the nasal bridge and comes closer to the person's lip.
Today, surgical techniques have changed, and almost all of the cartilages shaved from the nose are re-implanted within the nose itself, and we no longer discard cartilage or bone. The best and strongest cartilages are also grafted at the nasal tip. With this technique, nasal tip drooping after surgery is prevented. The thicker the nasal skin, the stronger and more robust the cartilage placed as a pillar at the nasal tip must be. Nevertheless, despite all these reinforcement efforts, a small percentage of nasal tip drooping still occurs, especially in fleshy noses that have thick skin.  To repair nasal tip drooping, strong cartilages must be grafted onto the tip cartilages so that they gain sufficient strength and achieve a beautiful shape, and this beauty is maintained over the long term.
There are various sources for cartilage grafting, which include: irradiated cartilage from a deceased person, artificial cartilage, and the person's own cartilage.
Dead (donor) cartilage is not useful for grafting onto the nasal tip because it loses its strength after some time and the nose becomes droopy again.
Artificial cartilage is very useful and effective for correcting nasal tip drooping and produces very good long-term results. However, artificial cartilage is always at risk of infection or extrusion through the nasal skin, and it is better to avoid using it as much as possible unless the patient accepts its complications. Of course, the likelihood of these complications is not high, but if they do occur, treating them is difficult and there is a possibility of damage to the nasal skin. Another cartilage source is the cartilage within the person's own body. Autologous cartilage is the best choice for grafting onto the nasal tip because it provides lasting strength and has no complications. Among autologous cartilages, the best source is the nasal septum, but unfortunately in revision surgeries, a useful amount of septal cartilage usually does not remain, as it was already damaged in the primary surgery.
 Another autologous cartilage source is ear cartilage, which is easily obtained and usually causes no aesthetic or functional complications for the ear. The drawback of ear cartilage is that it does not have very high strength and cannot play an effective role in repairing the drooping of fleshy nasal tips. Another autologous cartilage source is rib cartilage, which is very strong and effective. Its only drawback is an incision of about 4 to 5 centimeters made on the chest, which usually leaves a slight stitch mark. Of course, in women, this incision can be concealed in the inframammary fold area. Another drawback of rib cartilage is the technique of using it, which, if not applied precisely, carries the risk of deviating the nasal tip. Rib cartilage is effective for correcting tip drooping in all types of noses and produces brilliant long-term results.
If suitable cartilage is grafted onto the tip cartilages to strengthen them, the drooping is corrected and repaired, creating lasting beautiful results for the individual.

Video: Was Your Nasal Tip Drooping When You Smiled? Not Anymore!

Elevating the Nasal Tip

One of the aesthetic defects that makes people inclined toward nose surgery is nasal tip drooping, which in profile makes the nose appear too long, and in full frontal view gives the face an unassuming and somewhat melancholy state.
If the nasal tip drooping is corrected, the face is given a prouder and more attractive state in the full frontal view, and in the profile and three-quarter views, the nasal length becomes more balanced. Of course, the degree of elevating the nasal tip must be performed within a specific and limited range; otherwise, it gives the nose a pig-like state that has no beautiful appearance at all.
 In the past, surgeons shortened the nasal cartilages to correct nasal tip drooping. The drawback of this method was that after some time, due to the force of gravity and the reparative processes inside the nose, in some individuals the nasal tip would descend again. For this reason, surgeons would raise the nasal tip too high to overcome this problem so that after some time the nasal tip would descend and come closer to their desired state. Raising the nasal tip more than desired had two major drawbacks. First, in some individuals the nasal tip would not descend to the desired level and the nose would remain in a pig-like state. Second, a large amount of the tip cartilages was removed for this purpose, and the nose became susceptible to respiratory problems and damage.
In modern methods, instead of shortening the nasal cartilages, auxiliary cartilages are grafted onto the tip cartilages that act as pillars, holding the nasal tip up and resisting gravity and the reparative processes of the nose. In these methods, not only is the nose not susceptible to damage, but it also becomes stronger and more robust; moreover, it is no longer necessary to raise the nasal tip more than required during surgery, and the surgical results will be more under the surgeon's control. 

Video: Correcting Nasal Drooping

Before and After Gallery of Noses with Drooping

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