Smiling deformity (crease) after rhinoplasty - depressor septi resection a permanent solution? (Photo)

Question

Hi! I need a revision rhinoplasty surgeon, preferably in Southern CA who can address a residual hump, raised nostrils and a smiling deformity (crease above smile that was not a result of grafts). I have heard that depressor septi muscle resection could be a solution. Also, is there a risk that a resection could lengthen the area above my upper lip or cause further smiling problems? Thanks in advance for your comments.

Jeffrey Jumaily, MD · Answer

Thank you for your question. The fold in the upper lip skin is due to dynamic muscle action when smiling. Cutting the depressor sometimes makes it less pronounced but there is a risk of changes in the smile. The remainder of nose changes will depend on what your nose looks like and what was done.

David Alessi, MD - Account Suspended · Answer

Resecting the depressor may help a little.  It rarely changes the smile adversely.  A trial of very low dose Botox can be useful.  Most of the line is from the main lip muscle.  Botox there would help but will distort the smile a bit.  If the line was not there before the first rhinoplasty, then this would indicate that the septi resection may be a bit more likely to help.  The residual bump, of course, would be something that an experienced revision expert deals with all the time.  Best wishes.

Smiling deformity (crease) after rhinoplasty - depressor septi resection a permanent solution? (Photo)

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