Droopy Nose Tip when Changing Facial Expression? Sides of Nose Rise Upwards?

ive had 2 nose jobs, but the sides of my nostrils connected to my cheek/face rise upwards when i smile/change my facial expression, which makes my nose look droopy. is there anything that can fix this? snipping a muscle? botox? it's a very snarly smile and if i place my finger i can feel it physically move upwards. it's extremely overactive and really upsets me. i dont think rhinoplasty can do anything. any suggestion would be great, thanks! even my surgeon said he cannot do anything.

Doctor Answers (5)

Snipping a Muscle or Botox for Tip Depression When Smiling

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      If the tip is actually drooping during smile as the alar areas rise, muscle division and partial removal can help.  Find the plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year.  Kenneth Hughes, MD Los Angeles, CA


Los Angeles Plastic Surgeon
5.0 out of 5 stars 230 reviews

Drooping tip after rhinoplasty

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The ala where they meet the cheek- that part is supposed to rise with smiling, so that part of what you describe is actually normal. What I think you are referring to instead is a diving tip, or drooping of the tip with smiling. That can be corrected surgically by providing support with a columellar strut graft, dividing the depressor septi muscle, or more extensive work if there is more involved such as a hanging columella or excessive length to the nose, etc. It is difficult to comment without photographs or seeing you in person. Each surgeon has a limit to what he or she thinks they can attain with any given surgery, and this limit depends on the experience of each surgeon with that type of surgery. Not all surgeons are comfortable with advanced techniques in revision rhinoplasty, which is a challenging type of surgery. I recommend consultation with a board certified plastic surgeon or facial plastic surgeon with experience doing revision rhinoplasty.

Anita Patel, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 12 reviews

Alar rises when smiling

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Dear Ashley, I see that you are located in Irvine. If you would like to come in for a complimentary consultation I would be happy to give you my expert opinion. I am located in Newport Beach. Your situation described above may or may not be surgically altered. A direct examination would be best for a proper diagnosis. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 133 reviews

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Alar rises with smiling

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Alar rise with smiling..that is natural. If the tip does not plunge then their is not much to do about that.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Nose moves when smiles

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if your tip droops when you smile that can be altered by incising and/or transposing the depressor septi nasi. however you are talking about the alae rising. this is natural action that may be exaggerated in your case. with that said I don’t think there is anything reasonable that can be done to stop or minimize that action.

 

Adam Bryce Weinfeld, MD
San Angelo Plastic Surgeon
5.0 out of 5 stars 34 reviews

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