How to fix my drooping nose when i smile? (photo)

Question

Hi there. I am a 24 year old female and I hate my nose when I smile. Specifically when I smile, otherwise I don’t have an issue with it. When I smile it seems my nose gets pointed way forward. Is there any solution to this? Hoping non surgical because I am tight on money. Let me know!

Marc Polacco, MD · Answer

This is a great question, and a very common complaint! There is a tiny muscle called the depressor septi that attaches the nose to the upper lip. When we smile, this muscle contracts, often pulling the nose downward. A permanent solution involves cutting the muscle. This may be performed during a rhinoplasty, or it could be performed as a solo procedure using local anesthesia in the office using incisions hidden just inside the nose. A neuromodulator such as botox, dysport, or xeomin could also be used to paralyze the muscle; however, this would need to be repeated every 3-4 months. I hope this information is helpful, and best of luck to you!

Nima Shemirani, MD · Answer

Hi @amichelle55! A non-surgical approach would be to inject botox into the depressor septi muscle.  This will relax the muscle and stop your nose from drooping down when you smile. Best of luck, Dr. Nima!

Eric M. Joseph, MD · Answer

Based on your photos, you may have a wide and asymmetrical nasal tip that droops with smiling. Adding filler to your nose would not lead to a narrower or lifted appearance. When it's feasible for you, consider consulting with several reputable rhinoplasty specialists. Thank you. Dr Joseph

Nelson Lee Novick, MD · Answer

Two microdroplets of Botox to the base of the nose (where the columella joins the topmost area of the white portion of the upper lip along with a small bolus of a lifting filler, such as Restylane Lyft, placed deep on the bone in the same region will usually satisfactorily, quickly and relatively inexpensive improve your issue. Hope this helps. Best of luck.

Jeffrey H. Spiegel, MD · Answer

Typically we would address this with rhinoplasty, but as you are overall happy there is another way using botulinum (botox for example) or fillers to tweak the nose.  This should reduce the downward appearance when smiling.

Olga Zilberstein, MD · Answer

You can inject botox into the depressor septi muscle and this will relax the muscle and stop your nose from drooping down when you smile. This takes 10 minutes and lasts up to 2 months.

Aaron Stanes, MD · Answer

Hello,Thank you for your question.The nose is a complex component of the face that has a number of muscles that contract when you smile, changing its shape.Based on your photos, it appears that the main issue is in fact the elevation of your nostrils when you smile, giving the impression that the tip is more prominent and droopy. This in itself it difficult to address. Anti wrinkle treatment can be used to relax these muscles, but you may not be able to smile naturally.An alternative option is to use a combination of anti wrinkle injections to the depressor septi nasi muscle (that normally pulls the nose tip down), and dermal filler to change the shape of the nose.While this won't stop the elevation of the nostrils, it can help the nose to look more balanced when at rest and when smiling.I would recommend an consultation with a cosmetic doctor who specialises in non surgical rhinoplasty to formally assess your nose, and advise on the most suitable options for you.Kind regards,Dr. Aaron Stanes, MBBS (Hons), Cosmetic Physician, Melbourne, Sydney & Brisbane, Australia.

Onir Spiegel, DDS, PhD · Answer

It's easy to correct a nose hump and create a nose tip flip with hyaluronic acid fillers. The procedure itself takes about 10 minutes and lasts at least a year. If you decide to go with a surgical rhinoplasty, at least you'll have a good start of what your nose would look like.  All the best from Boston, Dr. Onir

How to fix my drooping nose when i smile? (photo)

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