Changing the position of the nose in surgery? (Photo)

Question

Hello . I had surgery two and a half years ago. My surgeon said that at the same time, in order to fix the gummy smile, we will pull your nose down a little and keep it in its new position with the septum extension so that the upper lip also comes down a little. After surgery I have chronic (intermittent) congestion. Also, runny nose when eating or in cold weather. Can this change in the position of the nose be the cause of these breathing problems - is there a change in the air flow pattern?

Steven M. Denenberg, MD · Answer

A septal extension involves putting cartilage in the nose that wasn't there before, and that cartilage can obstruct the breathing. It's hard to know why the nose is runny. One explanation is that there was a change in the airflow pattern, and some of the soft tissue in your nose is getting less air past it, and some is getting more, and the tissue that's getting more reacts by secreting more mucous. Have you tried some antihistamines to see whether they make a difference?

I'm curious whether the extension changed your gummy smile. I've never heard of using a septal extension for that, and your mouth/lips/bottom of nose look about the same to me. Did it work?

Philip S. Schoenfeld, MD, FACS · Answer

Dropping your nasal tip a few millimeters with the use of the septal extension graft is not going to cause you to have new onset nasal congestion.  The front view of your nose along with the profile likely shows some internal nasal valve stenosis and perhaps and inverted V deformity.  I would absolutely see a double board certified facial plastic surgeon who can also evaluate things such as nasal valve collapse, septal deviation, inferior turbinate hypertrophy, and vasomotor rhinitis.  One or several of these issues could be present and easily addressed.

Changing the position of the nose in surgery? (Photo)

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Changing the position of the nose in surgery? (Photo)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.