Impaired function of transverse nasalis muscle post maxillary advancement - can this be addressed with a rhinoplasty?

I have seen often my patients who have undergone LeFort I osteotomy develop and recess just below the nostrils and that can cause widening of nostrils and can be asymmetric as well. It can certainly be improved with alarplasty.
Regards
Dr. Janjua

Hello and thank you for your question. There are many techniques in rhinoplasty that can be used to address the changes in the nose that occur after jaw surgery. With good surgical technique, you could likely have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

With certainty, there are no rhinoplasty maneuvers that I'm aware of that can restore functions to somebody's nasalis muscle. I think your question would be best addressed to your maxillofacial surgeon. If your osteotomy was less than 1 year ago, the function of the muscle may return. I hope this helps! Sincerely, Dr Joseph

Hello! Thank you for your question. What you’re describing, asymmetrical nostril movement after a Le Fort I osteotomy, is actually a known but uncommon outcome. The transverse nasalis muscle helps compress the nostrils, and during maxillary advancement, it can be partially transected or displaced. If the muscle doesn’t reattach or heal symmetrically, one side may not move normally, leading to a subtle slant or asymmetry of the alar base when smiling or pursing the lips.
In many cases, this issue can be addressed during a rhinoplasty procedure, but it requires a surgeon experienced in both nasal anatomy and functional rhinoplasty techniques. The approach may involve repositioning or reconstructing the affected alar muscles, sometimes using small grafts or precise suturing to restore symmetry, along with standard tip refinement or alar base adjustments to optimize appearance. Because this is a delicate functional concern, outcomes depend on the severity of the muscle disruption and the individual anatomy, but careful correction can often improve both function and aesthetics.
A consultation with an experienced rhinoplasty surgeon would help confirm whether these techniques are right for your anatomy and goals, but what you’re describing is something that can often be improved with precise tip reshaping and cartilage adjustement.
I hope this answers your question. Best of luck!
Justin Buro, M.D.