Post rhinoplasty...can't smile (Photo)

Hello! I'm 8 days post op from my open rhinoplasty where I had an alar base revision and my tip refined. I got the splint off yesterday and I haven't been able to smile. My upper lip does not got past my upper teeth and when I purse my lips (duck lips) I feel a little pressure at the base of my nose between my nostrils. Is this a normal side effect of the surgery? Is there anything I can do to regain my smile faster?

Doctor Answers 9

Heaviness of the central upper lip with smiling may be temporary after rhinoplasty surgery.

We nearly always place a columellar strut cartilage graft during rhinoplasty surgery to add tip support, and to help maintain tip position. These grafts may be 2-3 centimeters long, and may extend from your tip down into the muscles of your upper lip. This may result in upper lip heaviness with smiling, and this has been temporary in our patients.

Hope this helps you.

Dr Joseph

West Orange Facial Plastic Surgeon
4.9 out of 5 stars 386 reviews

Smiling after rhinoplasty

The ability to smile is commonly impacted by rhinoplasty initially. This is often due to swelling.  It often gets better with time.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Postoperative recovery after septorhinoplasty / nose surgery

Agree with my colleagues comments as well- it is still early in terms of swelling; I usually tell my patients that most of the swelling is present for the first 1-2 months and then gradually goes down over a year..


At 8 days, you are extremely early in your recovery period and the nose is expected to be quite swollen at this point. The majority of the swelling will resolve in 3-6 months, and will continue to resolve as your nose heals for up to 1-2 years. You have not reached your final shape as the nose will continue to heal and reduce in size for up to a year. Once it does reach its final shape you may be more pleased with the appearance of your nose.

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 45 reviews

Swelling after rhinoplasty

The combination of the open rhinoplasty and alar base revision, along with just the injections of local anesthesia will lead to swelling that will affect your smile for more than 7 days. Be sure to follow up with your plastic surgeon, since the internet can only accomplish so much.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 26 reviews

Swelling after rhinoplasty

Thank you for your question. Remember, you should always address any post-operative concerns with your primary surgeon. It is very important to remember it takes 6 months for 90% of the swelling to resolve after a rhinoplasty. During this waiting period, several treatment options can reduce the swelling. First, post-operative taping is imperative to decrease swelling and mold the shape of the nose. This can be performed for a minimum of 2 weeks with recommendations commonly for 3 months. Second, a short course of oral steroids (Medrol dose pack) can be beneficial in the early stages to decrease swelling and pain. Third, I commonly use a dilute solution of Kenalog with Marcaine to decrease swelling of the nasal tip. I hope you find this helpful. Best of luck in your recovery!

James Fernau, MD, FACS, member of The Rhinoplasty Society

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 64 reviews

Smile after rhinoplasty

Swelling is a normal response after surgery and will resolve with time. I always ask my patients to call my office with any questions and concerns.  Continue to check with you surgeon to make sure the healing is normal

Michael Sullivan, MD
Columbus Facial Plastic Surgeon
4.9 out of 5 stars 76 reviews

Smile question post rhinoplasty -8 days

With an open rhinoplasty and alar base reduction it is not particularly unusual to experience minor swelling that can affect smiling. Try not to worry as this will improve with time. Share your concerns with your physician and follow any recommendations about your post operative care. I would expect further improvement without any Rx or therapy required. Best wishes.

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

8 days post op, some advices:

Thank you very much for enquire.
It's too early to make value judgments with only eight days after a rhinoplasty.
Swelling after a rhinoplasty depends of the surgery complexity.
In this regard, the nasal swelling Post-op It can last from two weeks to two months.
To reduce this swelling, I recommend you perform delicates daily lymphatic drainage massage therapy over the face (around the nose) avoid sun exposure, and take pain/inflamation pills, as your surgeron precribe you.
Kind regards,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 149 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.