Depressor Septi Muscle – Improving a Droopy Nasal Tip with Rhinoplasty Surgery

Blog post - depressor septi muscle droopy nasal tip

Washington DC rhinoplasty patients want to improve a variety of aspects of the nose while keeping a natural appearance. The three top rhinoplasty requests from the best plastic surgeons or top rhinoplasty surgeons include

  • reducing a nasal bump
  • improving nasal symmetry
  • elevating a droopy tip

The post discusses some methods to help lift a droopy nasal tip by modifying the depressor septi muscle.

What causes a droopy tip?

A droopy tip can be due to a variety of factors, including the nasal tip cartilage, nasal septum, muscle, and bone. These factors can contribute to a droopy tip to various degrees. One of the most common methods to improve a droopy tip in rhinoplasty includes reducing or cutting the depressor septi muscle, which is normally present for those with a plunging or droopy tip when smiling.

What is the depressor septi muscle?

Blog post - depressor septi muscle droopy nasal tip

The depressor septi muscle (drawn in pink) connects the central nose to the upper lip.

The depressor septi muscle is a common factor in droopy nasal tips. This muscle connects the central base of the nose and upper lip. Patients with a very strong depressor septi muscle often also have a very droopy nasal tip. These patients may also have a relatively short upper lip or a gummy smile too. Smiling or facial animation activates this muscle (among several facial muscles) which can pull on the nasal tip downward.

Blog post - depressor septi muscle droopy nasal tip

Before rhinoplasty photographs demonstrate an active depressor septi muscle contributing to a droopy nasal tip.

How is the depressor septi muscle reduced with rhinoplasty?

The depressor septi muscle is commonly reduced by plastic surgeons who perform closed (endonasal) rhinoplasty. External incision is not required, and the depressor septi muscle can be addressed via internal nasal incisions or an incision hidden in the gum line inside the upper lip area. Sutures gradually dissolve with time.

Reducing, cutting, or detaching this muscle may be performed in isolation or as part of an entire rhinoplasty (ex. hump reduction, etc). Some with a droopy nasal tip may need additional maneuvers, such as sutures, cartilage reshaping, and/or cartilage grafts, to fully address a droopy tip. Rhinoplasty is specific for each patient. Some patients may notice a small, subtle effect with upper lip length after depressor septi muscle reduction.

Blog post - depressor septi muscle droopy nasal tip

Before and after rhinoplasty photographs. A dynamic droopy tip was improved by reducing the depressor septi muscle via a closed (endonasal) rhinoplasty. No other changes were made to the nose in this minimal rhinoplasty.

Blog post - depressor septi muscle droopy nasal tip

Before and after rhinoplasty photographs. The depressor septi muscle was reduced via a closed (endonasal) rhinoplasty, in addition to cartilage grafts and sutures to improve a droopy nasal tip.

What are alternatives to depressor septi muscle reduction?

Non-surgical rhinoplasty with Botox® or Dysport® injections can help relax this muscle. This method of non-surgical rhinoplasty is a quick office procedure and last approximately 3 months. Results without surgery tend to be more subtle as compared to surgical rhinoplasty. Botox injections can be an initial step, then later perform rhinoplasty for a more permanent or dramatic change as desired.

What are your questions on rhinoplasty or surgery for a droopy tip? Share your thoughts below.

18 Responses to Depressor Septi Muscle – Improving a Droopy Nasal Tip with Rhinoplasty Surgery

  • Ammara says:

    M 27 .. my concirn is that when i smile my teeth r less visible n my nose droops down badly .. what can i do for improving a big smile

    • Houtan Chaboki, M.D. says:

      Some patients with a droopy nasal tip also have a gummy smile, which can be treated temporarily with Botox or Dysport injections. Speaking with a specialist can help determine appropriate options to potentially improve a smile.

  • Shirley says:

    Hi I had a nose job about 7 years ago but as soon as the plaster came off the top had dropped I looked into injections but the nurse said it wouldn’t b advisable because I had surgery what do you think are my options

    • Houtan Chaboki, M.D. says:

      Thank you for reading the blog. Revision rhinoplasty is highly variable, even for focused areas of the nose. Injections can potentially be an option to reshape the nose, while generally surgery would be required for more dramatic and permanent changes. Office consultation and examination would required to help determine appropriate options in revision nose surgery.

      Dr. Chaboki

  • Marie says:

    Is the depressor septi muscle the only muscle that can be reduced or cut during a rhinoplasty? I have very strong muscles in my nasolabial folds, which cause my nostrils’ corners to raise while also creating deep creases in my around my upper lip. I don’t want to get fillers and was wondering if there’s a way to modify the strength of these muscles pulling on my face and creating severe and deep lines.

  • Jomana Mourad says:

    I had rhinoplasty performed over 10 years ago. After the surgery my upper lip is much longer and when I smile my upper lip covers my teeth.
    I had a perfect smile before the surgery.
    Is there any way a surgeon can reattach the DSM muscle ?

    • Houtan Chaboki, M.D. says:

      Thank you for reading the blog!

      For patients with a long upper lip, we may recommend upper lip lift surgery. This surgery removed excess upper lip and allows more of the red part of the lip and teeth to show.

      Read more about lip lift in our blog.

      Dr. Chaboki

  • Larissa Sanchez says:

    Hello i have no issues with my nose other than when i smile it droops. However i dont want to have surgery because other than the tip drooping i like my nose, can a patient just have the depressor septi muscle resected or do you have to have surgery? what non surgical option is there

    • Houtan Chaboki, M.D. says:

      Thank you for reading our blog!

      Muscle resection is surgery, even if relatively minor. A nonsurgical option that a patient may consider is relaxer injections such as Botox, which can temporarily reduce droopy tip with smiling.

      Read more about nonsurgical rhinoplasty with filler and relaxer injections.

      Dr. Chaboki

  • Charlotte says:

    Due to haemophilia, no surgeons will perform rhinoplasty. I’m happy with my nose but when I smile, my nostrils spread a LOT. Can botox be used to try and reduce the flare please? After many calls with different worldwide clinics, they all say I’m too high risk with my bleeding. Botox is a safer option. I realise it’s not a miracle cure but any improvement is gratefully accepted. I don’t smile due to my excessive nasal flare.

    • Houtan Chaboki, M.D. says:

      Thank you for reading the blog!

      For those patient not ready or unable to have surgery, then nonsurgical rhinoplasty can be considered. Patients should speak with their rhinoplasty surgeon regarding any concern.

      Dr. Chaboki

  • Amaan says:

    I have slightly curved nose which I find very insecure. It is not fully curved like a hawk nose but it is curved a little bit. I really want to know that can the massage be helpful reduce the sagging of the nose downwards. It even looks slightly curved while I am not smiling. please tell me how can I fix it to get a straight and sharper nose. By the way, I am a male.

    • Houtan Chaboki, M.D. says:

      Thank you for reading the blog!

      Massage of the nose has not be shown to reduce a bump or to improve the curvature of the nose. For those not ready for surgery, one may consider nonsurgical rhinoplasty as a possible option. Patients should be evaluated by a surgeon to help determine appropriate treatment options.

  • Sasha says:

    I’m interested on a tip plasty to subtly reduce the size of my tip and maybe make it more symetrical. I have a minor bump on my nose I have no intrest in getting rid of (its tiny and adds character :)), but I worry by reducing the size of my tip it will emphasise my nose bump from the side profile and give it a hooked appearance? Is it posible that my larger nose tip helps blend out the bump? Or am overthinking it?
    (I understand if these questions can’t be answered without seeing me in person, but it’s worth a shot)
    Also, my nose is downturned. I don’t mind it when my face is resting – actually, I think lifting it wouldn’t suit my face and will make the space between my nose and upper lip look long and funny – but when I smile, my nose droops alot. I’ve seen with botox people can keep the nose the same when resting, but paralyse the muscle that drags it down when smiling. Are the same results possible with a rhinoplasty? It would be a dream to keep my down turned noses natural shape (well almost, I still hope to reduce the tip size) without it being emphasised every time I smile.

    I hope my questions make sense because I’ve tried googling them I cannot find a single result so maybe I’m just not working I right.
    Honestly, I’ve tried researching but I still get confused trying to figure out how changing one thing will affect the other.

    • Houtan Chaboki, M.D. says:

      A rhinoplasty consultation would be appropriate to help determine if surgery is appropriate. Rhinoplasty can help many aspects of the nose, such as bumps and a droopy tip. Thank you for reading the blog.

  • Tony says:

    Hey i like my nose at rest but when i smile my nostrils pull upwards and sideways, i heard cutting depressor septi wont help my situation because my tip of the nose isnt the problem but the sides of the nose going upwards, can cutting the other muscles near the sides of the nose help my issue? Thanks.

    • Houtan Chaboki, M.D. says:

      Thank you for reading the blog. Many rhinoplasty surgeons avoid cutting muscles on the sides of the nose. Botox (or similar) injections are an alternative option one can consider to temporarily weaken the muscle.

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