My Nose Expands and Looks Really Big and Flat when I Smile. Is There a Way to Fix That Without Losing Its Character? (photo)

Your photo shows a flattened bridge and most likely a wide alar base. The standard approach to narrow and project the nose out of the plane of the face is a bridge implant or graft and narrowing the base width. I do not know what you mean by character of the nose. If the look/shape is changed I would think you would consider the character changed as well as the ethnicity to some degree. You could opt to leave the tip and base unchanged if you want a less dramatic difference.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Hello,I saw your picture and although they are only a representative of what I may see in person, I think you have to be careful in making changes to your nose. It is a part of your body that is a focal point on appearance but caution needs to be taken in that changes that may affect the appearance can have consequences in function such as breathing and smell. Smell is a function that can affect taste. Many techniques that are used by surgeons to narrow a nose both at the tip and nostril tend to reduce the free flow of air through the nose. An expert rhinoplasty surgeon with significant experience can give you the best functional and aesthetic assessment of your situation and give you the most accurate expectation of results should you pursue surgery. Thick skin does not lead to fine detail in the tip area and nostrils can look unnatural if a routine alar wedge is removed.  There are techniques that can be performed to improve these areas without an unnatural look.

Great question. There are a lot of muscles on the face that are involved in smiling, and some of those muscles also connect to the sides of the nose. Therefore, when we smile, it pulls the nose up and outward, and every nose gets wider when the person smiles. Some get wider than others, and some of that depends on the laxity of your skin, cartilage, width of the nose, etc. From the photo it appears that you have a wide alar base. This is something that could be corrected surgically if it is particularly bothersome to you, but I would discuss your goals with a plastic surgeon and see if he or she thinks it's possible to give you the outcome you are seeking.
-Dr. David Mattos, New York Plastic Surgical Group