What Is Nasal Tip Rotation?

Dr. Michael Menachof Headshot
Dr. Menachof, MD, FACS has performed thousands of facial plastic surgery procedures in over 20 years of experience. He has been recognized as a Fellow by multiple academies, named one of America’s Top Facial Plastic Surgeons continually since 2003 and is featured in multiple national publications.

Do you have what some call a “droopy nose,” where the tip of the nose naturally points downward or droops when you smile? The drooping nose is also called nasal tip ptosis, which can be present from birth or the result of a previous rhinoplasty. If you have a droopy nose tip when smiling or a droopy nasal tip at rest, you are a candidate for a nasal tip rotation, a surgical procedure where the tip of the nose is adjusted to a more desirable angle.

Keep in mind that nasal tip rotation refers to an upward tipping of the nose, increasing the angle between the upper lip and the bottom edge of the nose. Decreasing this angle would constitute nasal tip derotation.

Causes of Droopy Nose, Also Known as Nasal Tip Ptosis

Nasal tip ptosis can occur for a variety of reasons: 

Nasal Tip Rotation
  • Elongated lower lateral or upper lateral cartilages
  • Elongated nasal septum or nasal bridge
  • Aging-related drooping due to gravity, weakened tip support and thinning nasal skin (like facial sagging)
  • Previous nasal tip surgeries that weaken support for the nasal tip
  • Shape and size of lower lateral cartilage; excess cartilage can cause a nose tip to droop
  • Weak attachments between septum and upper lateral cartilage
  • Accidental ptosis through traumatic deformation

No matter the cause of the drooping nasal tip, consult with your surgeon to see if a nasal tip correction is the solution for you. If you are experiencing breathing problems due to a drooping nasal tip, ptosis correction through rhinoplasty may be a viable solution for helping you breathe easier once again.

How to Measure Nasal Tip Rotation

INose anglesf you have the drooping nose tip and would like it corrected, the first step is contacting a surgeon for a nasal tip consultation. The surgeon will measure the nasolabial angle, which is the angle formed between the bottom edge of the nose and the upper lip.

There are different desirable nasolabial angle ranges for men and women. The golden window for men is between 90 and 100 degrees, while a slightly more rotated tip is the preferred look for women between 95 and 108 degrees. A surgeon will always diagnose nasal tip ptosis by measuring the nasolabial angle before surgical correction, while a post-operation angle measurement verifies a successful nasal tip rotation.

The Nasal Tip Rotation Procedure

In order to correct nasal tip ptosis, the surgeon performs what is called a nasal tip rotation, adjusting the nasolabial angle to the desired window. There are a variety of ways to perform a nasal tip rotation through rhinoplasty.

Droopy Nose Rhinoplasty Procedure

Your surgeon can use a number of surgical techniques to perform nasal tip rotation, or nose tip lift, via rhinoplasty. Surgeons often use the open rhinoplasty technique for this procedure as opposed to a closed rhinoplasty. Open rhinoplasties feature incisions on the interior of the nose as well as the exterior of the nose along its bottom edge.

Surgical solutions for nasal tip ptosis include:

  • Trimming excess cartilage from nasal tip
  • Shortening of nasal septum
  • Reduce length of lateral cartilages on the outer edge of each nostril, raising the “tripod” of the nose
  • Suturing lower lateral cartilages to perform tip lift
  • Increasing support of nasal tip through graft or columella strut (the columella is the bottom edge of the nose connecting the two nostrils)


Tip rotationThe style of tip rotation used by a surgeon is completely dependent on each individual nose. Some drooping noses may require more severe surgical correction with a combination of the above procedures, while others may be fixed more simply. Always consult with your doctor to determine which solution best fits your nasal needs. Now that you know some of the different avenues surgeons take for nasal tip rotation, make sure to ask your surgeon about his or her experience with nasal tip correction. Browse through before and after photos of your surgeon’s rhinoplasty work to see finished results of previous nasal tip corrections. Additionally, verify that your surgeon is board-certified and has a high volume of previous rhinoplasty experience.

The nasal tip ptosis surgery cost can range from $4,000 to $6,000. As always, consult with your surgeon about the droopy nose rhinoplasty cost for your specific case.

If you have a droopy nose tip as a result of a previous rhinoplasty, you may be a candidate for revision rhinoplasty. Speak with an experienced surgeon for options to solve your specific nasal shape concerns.

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