The Aging Nose

As we age, the nose undergoes many changes.  How much the nose changes depends on your genetics, gravity, and the physiology of the nasal skin, fat, connective tissue, muscle, and bone.  UV exposure from the sun and tanning beds accelerates this process.  These changes can lead to nasal symptoms and difficulty breathing through the nose later in life.

Most notably, gravity produces sagging of the nose.  As the nasal skin becomes thinner, drier and less elastic, it is more susceptible to gravity effects over time.  Progressive descent of the nasal tip pulls on and separates the connective tissues between the cartilages at the end of the nose resulting in lengthening and enlargement of the nose.  This descent and downward rotation of the nasal tip can create a relative hump on the nose or accentuate a pre-existing hump.  This movement also results in relative retraction of the columella (the skin between the nostrils). 

These changes to the outside of the nose from the aging process can produce nasal obstruction.  The drooping and heaviness of the cartilage tip changes the airflow patterns through the nose which can produce obstruction and difficulty breathing through the nose. 

As the cartilage and thin muscles age, they can become weaker and less elastic.  The cartilage and muscles at the tip of the nose are designed to hold the nostrils and valves “sprung” open with breathing.  As the nose ages, these structures collapse and are no longer able to hold the nostrils open as well. 

Some of these changes you may have noticed personally or seen in your family members.  If you have noticed any of these changes, you are not alone! Please call our office to discuss options!   

Reference: Slavit DH et al. Rhinolift operation in the treatment of the aging nose. Otolaryngol Head Neck Surg 1990;103:462.

Blog figure:

A. Normal anatomic relationship of the upper and lower lateral cartilages.  B. Anatomic relationship of the upper and lower lateral cartilages often seen in the aging nose.  Note that the cartilages are no longer overlapping.

Kaete Archer, MD Facial Plastic Surgeon

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