Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 28.
doi: 10.1007/s00266-025-04966-x. Online ahead of print.

Effect of Depressor Septi Transposition on Preventing Tip Droop During Smiling in Tongue-in-Groove Tip Plasty: A Randomized Controlled Trial

Shayan Dasdar  1 , Nika Kianfar  1 , Mosleh Kadkhoda-Mohammadi  2 , Babak Saedi  3
Affiliations

Effect of Depressor Septi Transposition on Preventing Tip Droop During Smiling in Tongue-in-Groove Tip Plasty: A Randomized Controlled Trial

Shayan Dasdar et al. Aesthetic Plast Surg. .

Abstract

Background and aims: Plunging tips caused by overactivity of the depressor septi nasi (DSN) muscle present common challenges in rhinoplasty. The tongue-in-groove (TIG) surgical technique has proven effective in correcting static tip drooping.

Objective: This study aims to assess the effect of DSN transposition on preventing tip drooping during smiling in TIG tip plasty.

Methods: This clinical trial was conducted at a tertiary academic hospital from April 2022 to July 2024. Fifty patients with plunging tips who were undergoing septorhinoplasty were randomly assigned to two groups: TIG alone (n = 25) and TIG with DSN transposition (n = 25). The primary outcome measured was the percentage change in the tip angle between relaxed and smiling poses, evaluated through preoperative and one-year postoperative assessments. Secondary outcomes included the position of the tip, the position of the alar, tip projection, rotation, and patient satisfaction measured by the Standardized Cosmesis and Health Nasal Outcomes Survey.

Results: The reduction in tip angle was significantly greater in both groups (TIG alone: from - 9.38 to - 5.80%, p < 0.001; TIG with DSN transposition: from - 11.57 to - 8.65%, p = 0.001). There were no significant differences between the groups in terms of tip angle (p = 0.518), tip position (p = 0.363), alar position (p = 0.239), or nasolabial angle (p = 0.287). Improvements in patient satisfaction scores were also similar between the groups (TIG alone: 15.62 ± 8.44; TIG with DSN transposition: 18.50 ± 8.64, p = 0.286).

Conclusion: Both TIG and TIG combined with DSN transposition effectively reduce dynamic nasal tip drooping during smiling. DSN transposition may not lead to a significant improvement in outcomes compared to TIG alone.

Level of evidence i: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Cosmetic techniques; Depressor septi nasi; Plunging tip; Rhinoplasty; Tip plasty; Tongue-in-groove.

PubMed Disclaimer

Conflict of interest statement

Ethical Approval: The study adhered to the principles of the Declaration of Helsinki, ensuring that ethical standards were maintained throughout the research process. All participants were thoroughly informed about the study steps and provided written informed consent. The study protocols were registered before the beginning of the research project (IRCT20080820001056N6) and got ethical approval from the Tehran University of Medical Sciences Research Ethics Committee (IR.TUMS.IKHC.REC.1400.155). Conflict of interest: The authors declare that they have no conflicts of interest to disclose. Informed Consent: Informed consent was obtained from all individual participants included in the study.

Similar articles

See all similar articles

References

    1. Neaman KC, et al. Cosmetic rhinoplasty: revision rates revisited. Aesthet Surg J. 2013;33(1):31–7. - DOI - PubMed
    1. Ghorbani F, Ahmadi H, Davar G. Patient dissatisfaction following rhinoplasty: a 10-year experience in Iran. Maxillofac Plast Reconstr Surg. 2023;45(1):7. - DOI - PubMed - PMC
    1. Sajjadian A, Guyuron B. An algorithm for treatment of the drooping nose. Aesthet Surg J. 2009;29(3):199–206. - DOI - PubMed
    1. Fred GB. Role of depressor septi nasi muscle in rhinoplasty. AMA Arch Otolaryngol. 1955;62(1):37–41. - DOI - PubMed
    1. Kosins AM, Lambros V, Daniel RK. The plunging tip: illusion and reality. Aesthet Surg J. 2014;34(1):45–55. - DOI - PubMed

LinkOut - more resources