My nose gets bigger and droopier when i smile - is there a less invasive procedure that would help? (Photos)

Question

What kind of procedures could I do to fix that? I prefer something that is not very invasive.. Thanks in advance!

Semih Yildiz, MD, FEBOPRAS · Answer

Comparing the resting and smiling profile photos, the tip rotates slightly downward with smiling; the frontal pair also shows normal soft-tissue and alar widening during expression. The change appears dynamic rather than a fixed enlargement, although these close images do not show the full face or exact smile mechanics.

For selected patients, a carefully placed neuromodulator injection into an overactive depressor septi nasi muscle can modestly reduce downward tip pull for several months. This is temporary and off-label, and incorrect placement can alter the smile, upper-lip movement, or facial symmetry, so it should be done by an injector experienced with nasal anatomy. Filler does not make the nose smaller and carries uncommon but serious vascular and vision risks. A lasting change requires structural tip support during rhinoplasty, sometimes combined with treatment of the depressor muscle. An in-person examination while smiling can determine whether a conservative injection trial is appropriate.

Eric M. Joseph, MD · Answer

Based on what we see, you appear to have a tension lip deformity, a long nasal appearance, excessive nostril show, and they droopy tip. Each of these entities may be repaired utilizing proper rhinoplasty techniques. I do not believe that there is a minimally invasive procedure that would benefit your condition. I hope this is helpful. Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. With good surgical technique, you could have an outstanding result. 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

Tanveer Janjua, MD · Answer

Your nose looks beautiful. I would not do anything. It can be hard to not make a change if you are self conscious about your nose but the risk reward ratio is not in your favor.
Regards
Dr. Janjua

My nose gets bigger and droopier when i smile - is there a less invasive procedure that would help? (Photos)

Answers (4)

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