Concerns About my Smile After Open Rhinoplasty (7 Weeks Post Op)

I wanted to fix a droppy tip & flared nostrils which occurred only when I smiled. I also mentioned that one of my nostrils pushed upward more & caused a noticable difference in my smile from one side of my face to the other. Since the surgery my nose does look thinner but the tip & issues with my nostrils are still the same. I really cant afford another surgery & want to know if its the swelling or is it still going to push upward like before?

Doctor Answers 5

Waiting for final result after Rhinoplasty

 IMHO, if your nostril or nostrils change position and shape when smiling this is most likely a nasal muscle issue.  When you smile you use the facial nerve which also controls the nasal muscles.  When the muscles contract they are pulling your nostrils down in an uneven manner. 

 Rhinoplasty is designed to change and improve the shape of the nose but rarely has the ability to resolve a nasal muscle issue.  IMHO, you should wait 6 months until your nose is healed, from the Rhinoplasty and if this still happens when you smile have some Botox injected into the nose to relax these muscles (perhaps on the side where the nostril is pulled down farther) to see if this resolves the issue.

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Smile and the World Smiles With You, Even 7 Weeks After Rhinoplasty

Hi RhinoNewbie,

Nothing to do at this point but patiently wait.  Even if you had all of the money in the world, you would wait about a year for your nose to heal.  I am sorry that your goals have not been met, but perhaps things will get better with time.  Good luck and be well.  Keep smiling. ;)

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Smile 7 Weeks after Rhinoplasty

Your smile should not be affected by rhinoplasty surgery. if the smile is different 7 weeks after the operation, it is probably secondary to facial swelling which will interfer with muscle contraction. Tip drooping should improve after surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Please send your pictures

 It would take 6-12 months to see the final result of rhinoplasty. You should discuss your concern with your surgeon. Your surgeon should be able to tell you if the final result will be close to your expectations.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Nostril Flare with Smiling

The cause of flared nostrils is the action of the dilator muscle of the nose.  It is typically not addressed with a rhinoplasty.  I suspect that this is a miscommunication between you and your surgeon.  To a certain extent, this is a habit and you can learn to avoid contracting this muscle with smiling.  It is also possible to use Botox to weaken the muscle.  Your best option is to have a discussion with your surgeon about this problem and try and find an acceptable solution.

Joseph Campanelli, MD
Portland Facial Plastic Surgeon
4.5 out of 5 stars 8 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.