Unhappy With Smile 1 Month After Rhinoplasty- Will It Improve?

Question

Hello, I am 3 and a half weeks post rhinoplasty, and I still have a terrible smile (no upper teeth showing, middle of the top lip unable to lift). i wonder how long i should wait before i am worried? i read some other answers from doctors which suggested it should be largely better after 3 weeks, but this is not the case for me. i am embarrassed and feel unattractive - given that a smile is one of the most important features of your face!

Gregory Turowski, MD, PhD, FACS · Answer

It is still quite normal you have trouble smiling, because it has been only one month after the surgery. It takes time for the numbness to go away. Patients report often less sensation/movement in the lip area. The numbness also is typical for the tip of the nose. Your smile is not the same because the nerves are not fully awake yet after surgery. It can take up to 6 months, but you will see improvement. Be patient and follow up with your surgeon.

Gary M. Horndeski, MD · Answer

Dear Berlin,

	1 month post rhinoplasty is evidently too soon for you to see improvement in your upper lip. Sometimes it takes a bit longer for some people to resolve this problem. Several things may be affecting your prolonged swelling, ie; certain pain relievers called NSAIDs, time under anesthesia, etc. So, please be patient as you are still very early in the healing process. I hope this info helps, Dr. H

Pablo Prichard, MD · Answer

In general, almost all noses are numb right after a rhinoplasty. In most cases its the tip that is numb, but this numbness can extend down to the upper lip, and in rare cases some of the teeth. There are nerves that are cut and stretched during a rhinoplasty, and it takes a long time for those nerves to start working again. This is true of an open as well as closed rhinoplasty, although it tends to be more extensive in open rhinoplasty. This could also be more extensive if a septoplasty is performed at the same time. This, along with the swelling, gives you a stiff, plastic type feel, and can give you an odd smile.  However, the nerves will start working and again, and your nose stiffness will go away with time. As the nerves grow back, you may feel some tingling, itchiness and on occasion pain.  This takes in most cases months, but can take years in rare cases. Extremely rarely, the numbness is permanent, although I have never seen such as case.Best Wishes,Pablo Prichard, MD

Darryl J. Blinski, MD · Answer

Please allow more healing time up to three months. Sometimes the swelling does not permit the upper lip to elevate while smiling. I doubt this is permanent but I can not in person examine you.

Ashkan Ghavami, MD · Answer

The smile is temporarily altered after a rhinoplasty. This is rarely permanent. It may be more dramatic of a change if you had nostril incisions for alar reduction. Typically all is well by the latest, 3 months or so.

	Revision surgery for the nose and or/lips can help in future if you still dont like your smile. If your surgeon made drastic changes to your muscles then this may be more of a long term issue.

Francis R. Palmer, III, MD (retired) · Answer

If your Rhinoplasty surgeon did dissection in the anterior septal spine area, which is midline just above the upper lip...the muscle that lifts the upper lip could be effected. Typically this is done during an extensive Septoplasty or to fill in a retracted columella with crushed cartilage or a man made graft. Ask if this was done. If so, the upper lip most often returns to normal function within several months. Hope this helps.

Unhappy With Smile 1 Month After Rhinoplasty- Will It Improve?

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