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Unable to Smile Propely at Almost 7 Weeks After Rhinoplasty

I had a rhinoplasty as I had an upturned nose. My doctor moved my tip downward, narrowed my tip and changed the naso-labial angle. At first my upper lip was covering my upper teeth but it got better, and now you can see my teeth but I still have a stiff lip and I cannot smile properly. He told me I will have to wait weeks and I would like a second opinion as how many weeks. thank you

Doctor Answers (11)

Heaviness of the middle of your upper lip is common after Rhinoplasty Surgery.

+4

I read your concern:

Nearly all of my Rhinoplasty patients have temporary heaviness of their upper lip when smiling. I place a columella-strut in nearly all of my patients: this type of cartilage graft is used to support your tip, and the bottom of it lives in the muscle of your upper lip. This results in some difficulty smiling for 6-8 weeks following rhinoplasty surgery. This has not been permanent or problematic in any of my patients.

Good luck with your healing.

I hope this is helpful for you.

Regards from NJ.


West Orange Facial Plastic Surgeon
5.0 out of 5 stars 270 reviews

Post-rhinoplasty smile

+3

Hi,

This is not an uncommon concern following a rhinoplasty. In fact, I usually tell my rhinoplasty patients that their smile will not feel the same for at least the first 3 months after the surgery. This is due to a combination of post-operative swelling and dissection around the columella, as well as dissection along the junction of the nose and lip. Believe it or not, patients tend to have some swelling even months out after surgery. As you mentioned, you have already started to see a change with more visibility of your teeth as the swelling starts to dissipate. It will likely only be a matter of time before you start seeing even more of an improvement. Good luck!

Dr.Sunder

Sarmela Sunder, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Limited Motion of Upper Lip after Rhinoplasty

+3

Your smile should return to normal over the next 2-3 months as swelling resoves. The stiffness is secondary to the work your surgeon did at the base of your nose.The improvement you describe will continue.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

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Smile after rhinoplasty

+2

It is extremely common for the upper lip and smile to be affected for months after rhinoplasty due to stiffness and swelling in the base of the nose

Sam Naficy, MD
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Keeping a Stiff Upper Lip After Rhinoplasty

+2

Hi Beatriz,

Keep an upper lip about this.  Your surgeon knows best.  It will likely take a few more weeks for your upper lip muscles to reattach and for your smile to return.  Good luck and be well, hope that you enjoy your new nose.

Dr. P

Michael A. Persky, MD
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Unable to smile after Rhinoplasty

+2

I'd give yourself 3-6 months for your smile to return to normal.  If the plastic and cosmetic surgeon dissected the tissues in front of the columella, this can weaken the nerve that raises the upper lip.  Most of the time this returns to normal function within a year following the Rhinoplasty.  IMHO, I would not consider any treatment or surgery until that year has elapsed.

Francis R. Palmer, III, MD
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De-Rotation CAN Change the Upper Lip

+2

You should expect some (usually very minor) changes in the upper lip as de-rotation of the nose can relieve tension in that area.  As the nasolabial angle changes to a less obtuse position, the lip can drop very slightly.  In most patients, this is not noticeable, however, in some it can be seen.  This is usually accentuated by the swelling in this area immediately after surgery.

As with all rhinoplasty, healing time is expected in order to allow for the swelling to resolve.  As the swelling and firmness fade, you may still notice some difference, but this should not stop you from accepting and enjoying your new nose if your surgeon has achieved your goals.

Of course, you should also address this with your surgeon, as he/she will be able to further explain precisely what was done. 

Paul K. Holden, MD
Phoenix Facial Plastic Surgeon
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Rhinoplasty San Diego

+2

In agreement with other responders, healing, resolution of swelling, softening of stiff tissues, and return of neuromuscular function after surgery are processes that occur gradually,  You understand this intuitively, as you mention that your upper lip lifts more than it did immediately following your procedure, but still not normally.  So you see, nobody can predict the future, and tell you the precise number of weeks until lip elevation is normal.  It is not  a problem that persists for a number of weeks, and then instantly resolves.  Every patient and situation is different.  You should see slow, steady improvement as time passes.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 38 reviews

Difficulty smiling after rhinoplasty

+2

It is difficult to render a professional opinion without examining your nose or having a picture to visualize it. Based on your descriptions, there remains some degree of swelling in your upper lip after your recent rhinoplasty and upper lip surgery. I would recommend you to wait for at least two months until majority of swelling has subsided, then if there is any issue with you upper lip and smiling, then talk to your rhinoplasty surgeon.  Good luck and good healing. Dr. Kevin Sadati

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

Stiff upper lip after rhinoplasty

+2

You have had a great deal of work done at the lip tip junction. Healing is a variable thing. I can't tell you how long but, just wait this should clear up.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.