Nose dips and spreads when smiling?

You should see a rhinoplasty expert for a consultation. In select cases, though, Botox injections into the depressor septi muscle (where the nose meets the upper lip midline) can help minimize the droopy nasal tip upon smiling but it won't help with the flaring of the nose. There is really no other non-surgical alternative, certainly not to the other issues you described. It also sounds that you have weak nasal tip support, which should be corrected. A rhinoplasty will likely be the best option, both for aesthetic and functional (nasal breathing) purposes, but as mentioned above, only a rhinoplasty expert with an in-office evaluation can make an appropriate recommendation for your specific case. Best wishes!

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  This is a very common issue which can be fixed with rhinoplasty.   Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their
results.   The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

A small amount of Botox can help prevent your nose from dipping during smiling. This is a very easy way to correct this concern. All the best,

Dr. Brace

Hello.  Thank you for your question.  It is difficult to assess your concerns without pictures to view.  However, from what you describe, it sounds like you have a "plunging nasal tip" which dips down when smiling.  This typically suggests weak lower lateral cartilages (tip cartilages) that are pulled downward by the muscles of facial expression during smile.  This can usually be addressed through an open, or closed, tip rhinoplasty by placing a columellar strut to provide support to the tip cartilages and resist the downward forces that cause the tip to "plunge" with smile.  There is no non-surgical treatment to address this problem.  I would encourage you to seek a consultation with a board-certified Facial Plastic Surgeon with extensive rhinoplasty experience to allow them to assess your individual anatomy, concerns, and goals, in order to determine the best treatment plan for you.  I wish you the best in achieving your aesthetic goals.

To prevent the nose from dipping when smiling requires releasing of the depressor septi ligament. This ligament pulls the tip down when smiling and animating. Releasing of the depressor septa ligament is usually done in conjunction with the rhinoplasty procedure.

The only way to fix what is bothering you is with a rhinoplasty. Since I think it's always best to know your options, I would suggest that you schedule a consultation with a board certified plastic surgeon in your area to be assessed in person and discuss whether or not it is worth it to you to have surgery.Kindly,Kouros Azar

The alterations that you notice while smiling are quite normal and related to the muscles of the nose. The only way to treat this problem is to have rhinoplasty surgery so that the muscle can be released and the nostrils can be manipulated. See board-certified plastic surgeon who is experienced with rhinoplasty procedures.Good luckDrBurnett#realself100

Relying totally on your description the movement of your tip with facial animation can be altered by cutting the small depressor septi muscle without making any other changes to your nose. Without a full set of pictures as described on my website or a personal examination I cannot be sure this would be the best approach for you.

Thank you for your question.Without photographs or an in-person examination, it is hard to give you accurate advice but it is most likely that you will need a tip rhinoplasty and/or alarplasty to correct this issue. I would recommend scheduling a consultation with a board certified plastic surgeon who specializes in rhinoplasty to have a physical examination of you face and nose done. Best of luck in your endeavors.Sincerely,

James Fernau, MD, FACSBoard Certified ENTBoard Certified Plastic SurgeryMember of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

The only way to correct the issues you describe is with Rhinoplasty surgery.  Consult with a board certified plastic surgeon for an in person exam to discuss your options.