Weird smile 5 months after nose job (Photo)

This issue was discussed at the last Advances in Rhinoplasty Meeting last summer.  It seems to more of a problem these days as rhinoplasty surgeons embrace more of the rigid structural grafting techniques with open rhinoplasty (typically).  This usually happens because either a stiff columellar strut or a columellar extension graft has been used to rigidly fix tip projection.  When you smile, then, the nose does not give like it did before and the lip creases under the muscle tension.  This still may improve over time in your case as swelling continues to resolve.  Give it more time before you worry to much about it.  It would be useful to know what was done in your surgery and to see photos.  Thanks.

An altered smile is somewhat common following rhinoplasty.  Changes to your smile can occur due to placement of a columella strut graft for tip support or may be the result of cutting the muscles where the nose meets your upper lip during surgery.  These changes generally resolve over time but if there is a visible crease then a simple shortening of the columella graft, if one was placed, would likely remedy this issue.  I would suggest waiting another several months prior to any intervention.

A smile might be altered after rhinoplasty. This affect usually resolves in the recovery process. A majority of the healing has occurred within the first several months, but plastic surgeons typically say 1 year for "final" results. If you haven't already, then speak with your rhinoplasty surgeon to review options.Best,Dr. Chaboki

This can be from swelling, and if so will likely go away with more time.. If you had significant grafting or muscle manipulation ( depressor division), it can play into it as well.