One of the great little secrets of facial plastic and facial cosmetic surgery is that when performing face and neck lifts or eyelid surgery or neck sculpting to reverse the signs of aging, often a handy little adjunct is to also correct the nose that has become droopier with age. Patients have told me that “as I get older, it seems my nose is growing and getting longer.” In fact, there is some truth to that. With age and gravity there is stretching of the tissues of the nose. Combine that with the tendency for the tip of the nose to drop when some people have very strong smile muscles and, in fact, the nose gets longer, appears bigger and less flattering as we age.
So for those patents in whom an unsightly nose is a significant, although not necessarily the most profound sign of aging, it does make sense to expending 20 or 30 minutes more during the surgical procedure to “add on” some minor – but never radical – changes to the nose. The hump is removed. The muscle that forces the tip down is released and the tip is gently raised rendering a more youthful and pleasant nose.