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

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

Doctor Answers 4

Your rhinoplasty would be limited in some accomplishments.

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Dear Hanne91;

Your nostrils are quite wide and the overall width of your nose, compared to the entire width of your face, is rather significant.  Smiling probably makes it worse because the cheek muscles pull the wings of the nose up and out to further widen the nose.

If your bridge is low, you may be well served by having the bridge improved either using natural tissue or an artificial bridge.  And there may be a place to narrow the floor of your nostrils.  Likewise, the tip might stand a little narrowing.  However, none of those things will prevent the nose from widening with smile.  Remember, other people have a problem where the tip of the nose depresses with smile; that is correctable.  Unfortunately, one cannot sever or paralyze the muscle that tend to widen the nose when smiling. 

Robert Kotler, MD, FACS
Facial Plastic Surgeon

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

Nose Expands and Looks Big & Flat When I Smile

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I'm sure that your nasal tip is big and flat when you are at rest, but becomes worse with facial animation and smiling. The tip and the nasal base can narrowed and and the tip can be augmented to increase projection and definition. It is normal for the nose to change when smiling. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews


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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.

Aaron Stone, MD
Los Angeles Plastic Surgeon


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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.

Albert W. Chow, MD
San Francisco Plastic Surgeon

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.