I hate how my nose spreads out and points down when I smile. What type of rhinoplasty can fix this? (photos)

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. You may also benefit from a cephalic rotation of your tip to turn
up your tip slightly and nasal tip deprojection to decrease the overall size of your nose.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hi Ashley,  Unfortunately nonsurgical rhinoplasty will not address your concerns. It is a procedure that is indicated in very few patients and almost all of those would get a better, permanent result with a rhinoplasty. This is also true in your case.  You would be an excellent candidate for a rhinoplasty.  It would reduse the size of your nose from the front view and profile.  Have a consultation with a Board Certified Plastic Surgeon to discuss your options.

Thanks for the pictures and question. I don't believe non surgical rhinoplasty can help the width of the nose or the downward direction with smiling. Fillers can hide a bump on the bridge etc but Not great for your type of concerns. Consult a rhinoplasty surgeon for a full assessment. Best wishes

Hi ashleynicolejones. Nonsurgical rhinoplasty works at camouflaging a hump on the bridge, or adding height to the bridge or adding more tip definition or projection. It is not very effective at rotating the tip though. Surgical rhinoplasty can lift the tip and correct a droopy tip, give the tip more definition and deproject your tip (push it back so it looks smaller). Good luck. Best, Dr H 

Every nose is different and unique to that individual. If the appearance of your nose concerns you enough to do something about it, it can be improved with a natural artistically performed rhinoplasty. What would be the best option and exact procedure would depend on an in person examination (not just an online consultation) and discussion about desired outcome. Excellent results can be achieved with either a closed or open technique.



Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you exactly what to do and how technically to do it based on two dimensional photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon with extensive rhinoplasty experience certified by the American Board of Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.



Robert Singer, M.D., FACS



La Jolla, California

A closed rhinoplasty approach can accomplish releasing the depressor septic ligament which pulls the tip down when smiling. Releasing incisions on the base of the available can also help  reduce the amount of lateral spread when smiling. For many examples, please see the link and the video below

You appear to have a bulbous tip and with an under-rotated tip. Elevating the tip and reshaping it would help you attain your goals. Consult with a rhinoplasty specialist in your area.

Hi Ashley,You are a good candidate for rhinoplasty surgery. The non-surgical approach would not benefit you. Non-surgical rhinoplasty fillers are mainly performed for patients who want to make their side profile appear straight/even.  To fix the nostril narrowing- surgery may require defatting the tip, cartilage grafting, and/or reshaping. In good hands, you should get a great result.  Feel free to email me your pictures for computer imaging. 

Best,Dr. S

Thank you for your question. This is a situation that occurs more occasionally with rhinoplasty patients, but is classic for an "animated nasal tip." I would have to see you in person to see how your nasal tip depresses during smiling. If this is indeed the case then you need a special, but simple maneuver during rhinoplasty or without rhinoplasty that cuts the depressor sept nasi muscle. This incision is through the inside of the upper lip and so adds no additional scar to rhinoplasty. But unfortunately surgical is the only way to really fix it permanently except Botox. Botox is possible, but you'll need injections every 3 months and this can get expensive over time. You can cut this muscle without full rhinoplasty but generally patients don't see any shape change in their nose except when talking and smiling. Therefore, most patients elect to have full rhinoplasty along with this. Your other nasal features can also be refined and brought into improved facial balance through surgical rhinoplasty as well. Up to you. Both surgical options are available. Just depends on if you want any re-shaping done. Summary of options: 1) Botox, 2) Cutting muscle alone, 3) Full rhinoplasty