Nasal aging and the plunging nasal tip

When it comes to the aging nose, it’s been widely assumed that as we age, the tip of the nose begins to droop and may need a “lift.” During the first day of presentations at Vegas Cosmetic Surgery 2014, Val Lambros, M.D., a plastic surgeon in Newport Beach, Calif., explained during his talk, “Nasal aging and the plunging nasal tip,” that the “plunging tip” - in patients who present for rhinoplasty as well as those with aging noses - is merely an optical illusion.

Today Dr. Lambros shared the results of a study that he, Aaron Kosins, M.D., and Rollin Daniel, M.D., conducted to examine the anatomy of the nose in a series of before and after pictures with and without smiles of 25 female patients who complained of a plunging tip. Their objective was to compare the change in position of the various anatomical nasal elements in smiling and static photographs.

Lambros et al took measurements of the tip, nasolabial and columella angles and also noted changes in tip, subnasale and alar crease.

What they found was that the nasal tip moves less than 1 mm when smiling. Based on study data, the plunging tip, he said, is merely an optical illusion created by movement of other anatomical elements, namely the alar crease and subnasale, which move up while smiling, making it look like the tip is falling.

They found similar results with a second set of patients with aging noses.

“The point is not that the aging nose ages exactly like a plunging tip, but there are distinct similarities,” Dr. Lambros said.

The study, “The plunging tip: Illusion and reality,” was published in the January issue of Aesthetic Surgery Journal.
 

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