Rhinoplasty with advancing age: Characteristics and management

The aging nose presents several unique challenges to diagnosis and management. Although classically it presents as a drooping nasal tip secondary to loss of tip support with a relative dorsal hump, there are associated changes in the nasal skin, bony architecture, and airway that mandate consideration. Methods of correction emphasize restoration of tip support with nondestructive suture techniques. Use of osteotomies is minimized. Airway patency is improved or maintained by restoring the internal nasal valve, often with dorsal spreader grafts. Finally, special consideration is given to the patients' unique expectations and motivation. Rhinoplasty in the patient with advancing age is a rewarding operative procedure if one follows the guidelines delineated here to optimize the functional and aesthetic results.