How to fix nose widening when I smile? (Photo)

Question

So I am wondering if an alarplasty will fix this since it seems like a muscle attachment issue because at rest my nose does not appear wide at the base, only when I smile. I am interested in a tip plasty ... I am not unhappy with my bridge I don't have a dorsal hump or wide bridge. However I do have a bulbous tip. My question is if I need both an alar plasty and a tip plasty? Or would doing a tip plasty fix the issue? Will any surgery fix the widening while smiling?

Andrew Miller, MD · Answer

The nose may widen when you smile because the tip doesn't have good support. This can be corrected along with the bulbosity in a tip plasty. The ala should be considered in relation to the tip at rest. If they are flared without smiling, then alarplasty can be done at the same time. Be sure to see a rhinoplasty expert for consultation.

Eric M. Joseph, MD · Answer

Everyone's nose will widen when they smile. If you have flaring nostrils when you are not smiling, depending on your examination, alarplasty may be considered for a narrower nasal base appearance. Thank you for your question. Sincerely, Dr Joseph

Tanveer Janjua, MD · Answer

Without photographs it is difficult to assess. Both can be done at the same time. The nostril widening on smiling or laughing can be improved with alarplasty.  This can be done without touching the nasal bridge. 
Regards
Dr. J

Steve Laverson, MD, FACS · Answer

Cheeks elevate and lateralize with smile. Nostril margins (alae) attached to cheeks, so also elevate and lateralize with smile. As a result, some observe their nasal base widens and tip/columella complex descends upon broad smile, seen in photos.

These can be amended surgically but we approach each situation individually because of variations among patient presentations and preferences.

These can be amended surgically but we approach each situation individually because of variations among patient presentations and preferences.

William Portuese, MD · Answer

A tip plasty accomplishes nearing a bulbous nasal tip. Osteotomies placed in the nasal bones accomplish narrowing the bridge line. An Alar-plasty accomplishes narrowing wide nostrils when they're out of balance with the rest of the nose. During the alar- plasty, releasing in the lateral ligaments underneath the nostril can help prevent the nose from widening dynamically when you smile. An Alar plasty can be performed as a standalone procedure under local anesthesia while rhinoplasty must be performed under general anesthesia for patient safety and comfort. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your rhinoplasty specialist wisely based on extensive experience producing natural results.

How to fix nose widening when I smile? (Photo)

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