Smile changed after rhinoplasty. Is there anything that can fix my smile ? (Photos)

Question

I had a rhinoplasty 3 years ago and my smile change so much. At first I was told that my smile will be back after 12 months, but after 3 years I see my smile still ruined. It is posible to do something to fix it?

Semih Yildiz, MD, FEBOPRAS · Answer

In the before-and-after collage, the postoperative smile appears to show less upper-lip elevation and a different amount of tooth display, although one still image cannot separate muscle weakness from scar tethering or a change in tip and lip support. At three years, further spontaneous recovery is less likely than during the first postoperative year.

Possible causes include scarring near the nasal base, disruption or intentional division of the depressor septi muscle, altered attachment around the anterior nasal spine, or less commonly nerve or lip-muscle injury. Ask the operating surgeon for the operative report and obtain an evaluation with facial movement at rest and during smiling. Treatment might involve scar release, targeted muscle repair, therapy, or carefully selected balancing injections, but each could worsen symmetry if the diagnosis is wrong. A revision rhinoplasty surgeon familiar with upper-lip dynamics can determine whether a corrective procedure is realistic.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can see from your photos If you can send 3 photos from the front and side profile from 95 degree angles, we can make an accurate evaluation. It is not possible to make an accurate evaluation with the images you specified, if you can send your own photos in a good light from the front and side profile, we can make a more accurate evaluation.
It would be better face to face consultation.
Best Regards!

Eric M. Joseph, MD · Answer

After 26 years of performing rhinoplasty surgery, we have seen patients have heaviness of their upper lip for many months. In all of our patients, their smile has returned to normal by one year after surgery, usually a lot sooner. We never cut the depressor septi muscle during surgery. Perhaps yours was severed to correct a droopy tip, in which case, it's not clear to me how one would go about repairing this. I wish I had better news. Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It would be helpful to see a more complete picture of entire nose. The base of your columella would need to be fully assessed to see if there is a graft blocking your smile. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Cengizhan Ekizceli, MD · Answer

Persistent changes in your smile after rhinoplasty can occur, especially if the nasal tip support was placed too rigidly or if the muscles around the upper lip were affected during surgery. Although it's been 3 years and healing is complete, that doesn’t mean the issue can’t be improved. A revision rhinoplasty could help by adjusting the nasal tip support, or non-surgical options like dermal fillers and Botox may help restore more natural upper lip movement. In some cases, a detailed facial assessment is needed to rule out any muscle or nerve involvement. Consulting with an experienced facial plastic surgeon is the best next step toward finding the right solution for your smile.

Smile changed after rhinoplasty. Is there anything that can fix my smile ? (Photos)

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