What is a drooping nose tip?
While a drooping tip is predominantly an aesthetic concern, it can also cause breathing problems because it has the potential to narrow the airways. Nose surgeons tend to consider a nose to be drooping if the nasolabial angle is less than 90º in men and 100º in women. “What’s the nasolabial angle?” you might well ask. Well, imagine your face in profile and draw an imaginary vertical line running from just behind your chin, up to where the nostril meets your cheeks, and then up to where your brow. Then draw another imaginary line, this one running from the tip of your nose to the bit where the bit in between your nostrils meets your upper lip. The angle between these imaginary lines is the nasolabial angle.
There are other methodologies, such as tip rotation measured against the Frankfort horizontal plane and calculating the columellar-facial angle, but they get rather technical and, in any event, are essentially just different ways of talking about the same thing. But if you go to a consultation and hear them talking about these other methods, don’t worry, they’re just talking about facial angles to measure droop.
If your nostrils flare up quite dramatically, it can give the appearance of a drooping tip, even if the nasolabial angle isn’t under the supposed technical threshold. There are also a good number of people who only find their nose tips seem to droop when they smile. This isn’t at all strange; in fact, most people’s nose tips will be drawn down slightly by smiling. This is due to the muscle behind your upper lip (called the depressor septi nasi) shortening as you smile, which tugs the tip of your nose downwards.
Why does my nose tip droop?
There are a number of reasons why the nose tip might droop. I’ve already mentioned smiling, where the muscle behind your upper lip pulls the nose tip down as you smile. Most of the time, however, it’s due to the structure of the different bits of cartilage in your nose. You have probably seen a skull before and noticed that there is a hole where the nose is—that’s because the rest is made up of cartilage. These fit and link together to form a sort of tripod structure, over which additional soft tissues lie, creating the nose you see in the mirror.
There are many different cartilages in your nose— exactly how many actually varies, depending on how your nose developed and how you choose to define the distinct cartilages—as a rough guide, we’re talking around eleven in total. They’re made of collagen, something you will see mentioned repeatedly across this site. Collagen is the most common protein in the body and one of its primary building blocks. Over time, collagen deteriorates, which leads to a number of characteristics associated with ageing, including a drooping tip. Fun fact: the old adage that noses (and ears) don’t stop growing is false; they do get bigger though, and that’s because the collagen deteriorates and can’t support the nose against the forces of gravity as it used to. This causes the subdermal structures to descend resulting in stretching of the skin and an enlargement of the area.
The size, arrangement and shape of the different cartilages determine the shape of your nose, as well as any drooping. As you get older, drooping will become more pronounced, for the reasons explained in the preceding paragraph. Since cartilage is comparatively delicate, blunt force trauma can often distort one or more of the cartilages and result in a differing shape.