How to correct an otherwise good nose that widens when smiling? (Photos)

Question

So after much research I've decided that while my nose is not perfect I don't want to change it. HOWEVER I do want to fix the fact that my nose looks like it pulls down when smiling. Is there a way to fully address this without changing the nose in rest? (I thought that could be done by cutting the depressor muscle but turns out that's less important than the nasiolabal angle!?)

Deepak Raj Dugar, MD · Answer

Hello, A closed scarless rhinoplasty is the ideal procedure for you. The goal is to finesse and enhance the nose without drastic change.  Meaningful refinement is the key.   All the same surgical maneuvers your nose requires can be performed with a skilled closed scarless surgeon.  Specifically for you, I would suggest narrowing the nasal bones to give a more elegant refined look to your nose from all angles. I would also suggest fixing your minor droopy tip by rotating the nose upwards to prevent the excess pulldown when smiling.Best of luck,Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty.  Your drooping nasal tip with smiling can be addressed with release of your depressor nasi septi muscle and tip support with a columellar strut graft.   Make sure you specifically look at
before and after pictures of real patients who have had this surgery performed
by your surgeon and not just a computer animation system.
The most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Mehdi Sina, MD · Answer

Hi,Thank you for including your photographs. There may be a few reasons why your nose drops when you smile: an overactive depressor septi muscle can be one, weak support at the tip can also be a factor or both. If you have an overly active depressor septi muscle, cutting it is an option, but before that you may benefit from a trial of botox/dysport to the muscle to see if it gives you the desired effect. A consultation with a rhinoplasty specialist will help clarify your options.Best,Mehdi Sina, MD

Geoffrey W. Tobias, MD, FACS · Answer

Hi Mooonp, this is a good question because many people have similar concerns about their nose when they smile. There are a couple of good solutions to this kind of deformity. The best way to deal with it is to strengthen the cartilage within the collumela which will tend to counteract the pull of your smile muscles that can create a droopy elongated tip. This type of graft can be easily placed through a closed scar less rhinoplasty. I personally do not recommend cutting the depressor muscles because this can cause a permanent deformity in your upper lip shape.Best wishes and good luck in your research.                                                                                          Dr. Tobias

How to correct an otherwise good nose that widens when smiling? (Photos)

Answers (4)

Answer: Correcting a Smiling Droopy Tip

Answer: Correcting a Smiling Droopy Tip

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How to correct an otherwise good nose that widens when smiling? (Photos)

Answers (4)

Answer: Correcting a Smiling Droopy Tip

Answer: Correcting a Smiling Droopy Tip

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.