I had rhinoplasty in 1/13. My smile was effected. It seems like the middle of my upper lip sags when I smile, hides my teeth.

About 6 months ago the doctor did revision surgery and removed something (collumnala??) in an attempt to correct the problem. It still persists. You can only see about half of my front teeth when I smile. Is it possible that a muscle was damaged during the original procedure? My doctor seems to think it looks fine. I don't.

Doctor Answers 3

Reduced Smile After Rhinoplasty

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Most of the time a diminished upper lip smile after rhinoplasty is a mechanical problem and is not due to muscle injury. It can occur any time a cartilage graft (or scar tissue) acts to impede upward movement of the central portion of the lip when smiling. This usually occurs when cartilage is added to the region of the columella - such as with a columella strut, elongation of the septum, plumping grafts or premaxillary grafts. Most of the time, it only takes a few months until the upper lip regains its full mobility. If the problem is caused by restrictive scar tissue, gentle massage or steroid injection may be helpful. Sometimes, you have to weigh the relative value of a small surgical modification. If this continues to bother you I would make an appointment to discuss it more thoroughly with your surgeon. Best wishes.

Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Smile affected

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Thanks for your question. It is important and highlights a critical and common condition. Frequently after a rhinoplasty surgery there can be altered sensation and appearance of the upper lip. This  is usually temporary but depending on the techniques used they can be permanent. Numbness and  stiffness are almost universal complaints for the first few weeks. Additionally if certain cartilage grafts are used the upper lip may be swollen or can sometimes have  new crease that develops when you smile. Ideally these are all things that are covered in detail during the surgical consultation. Obviously speaking with your surgeon is the best resource. Hope this helps. 

Julian W. Dixon, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

I had rhinoplasty my smile was effected.

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The first year after rhinoplasty there can be some stiffness in the tip of the nose and sometimes the upper lip if the columella was strengthened, however things ordinarily settle by the end of the year. We can't see what is up and you might have to consider a second opinion in you area if you don't think things look right. Muscle damage is not likely.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 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.