How to fix flared nostrils and downward pointing nose when I smile? (photos)

Dear SKS:I often hear rhinoplasty patients address the same concern you share related to being displeased with the look of their nostrils. Often, wider nostrils can create the appearance of an oversized nose that does not fit with the rest of your facial features. When I examine a patient and their nostrils are either too large or wide, it does take the attention away from your eyes and face in a manner where there is a disproportionate amplification placed on your nostrils.Regarding your concerns about the tip of your nose pulling down to a point, that involves surgically correcting your nasal tip in a procedure that is commonly referred to as nasal tip rhinoplasty. Lastly, if you are suffering from a deviated septum that can cause many issues related to air flow and breathing and be a life long discomfort to a patient. However, surgically correcting a deviated septum will not change the appearance of your nose.My advice to you would be to research a Board Certified Facial Plastic Surgeon that specializes in rhinoplasty surgery, specifically tip rhinoplasty and septoplasty surgery. It is a very personal decision to undergo rhinoplasty surgery and you need to consult with a surgeon that has a unified vision with you so that you are pleased with your desired surgical results.I wish you the best of luck as you work on improving your overall appearance and health. Sincerely,Philip J. Miller, MD, FACS

It is pretty common to have a nasal tip that droops with smiling because it means that you are lacking some support in the tip. Also, there are muscles in the face and nose that pull out the nostrils when smiling. Rhinoplasty can give the tip more support so it doesn't droop down or pull out as much when smiling and the septoplasty can be done at the same time. Be sure to see a rhinoplasty specialist for consultation. 

One of the most gratifying procedures is alar plasty.  The nostril flare can be controlled and the width of the nose can be reduced significantly.Reduction of the dorsal hump can be accomplished at the same time.  The whole procedure takes about an hour and a half to 2 hours at the most.RegardsDr. J

Thanks for reaching out.  The solution to your problem is straight forward. Weir excisions are carried out by making an incision at the base of your nostrils and tightening their footprint.  This will result in reducing the amount your nostrils flare out.  In regards to the tip of your nose being pulled toward your lip when you smile, this is caused by excess depressor muscles.   This can be improved by a small incision inside your nose and cutting the attachments of this muscle.  Your septum can be addressed with a septoplasty and can be approached with a closed technique.  I would recommend to anyone getting Weir excisions not to undergo open rhinoplasty at the same time as this would greatly reduce the blood flow to the tip of your nose.I hope this helps :)

Thank you very much for sharing your concerns with us.Through rhinoplasty we make small changes, but that is quite noticeable. After having analyzed all the info. and photos provided to us, i recommend you perform a Full Rhinoplasty, includding narrowing of the nasal base, with nasal bones treatment, and alar and triangular nasal cartilages shaping.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully,Dr. Emmanuel Mallol Cotes.-

Hello and thank you for your question. Based on your photograph, you may benefit from a tip narrowing and refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. Your plunging nasal tip with smiling can also be addressed during surgery.  The most important aspect is to find a surgeon you are comfortable with. With good surgical technique, you could have an outstanding result. 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.Harvard-trained plastic surgeon

 A  closed rhinoplasty procedure can accomplish shaving down the dorsal hump, narrowing the bridge and refining the tip. The tip can also be lifted with  a tip-plasty. A rhinoplasty is considered cosmetic, and must be paid for by the patient. Functional nasal surgery performed is on the inside of the nose to improve air flow, such as a septoplasty. A septoplasty is only performed for airflow  improvement, and will not affect the shape of the nose. For more information and many examples about the differences between a rhinoplasty septoplasty, please see the link and video the video below

Hello Sks210,You indicated your problems only exist when you smile, which represents an active motion as opposed to rest.  For the nose being pulled down, you can either use Botox on a muscle that is there or if you are undergoing a septoplasty, that muscle can be surgically removed.  You might want to use Botox first to see how removing that muscle looks, as it can affect your smile.  For the widening of the nostrils, if you like your appearance at rest then surgery is not recommend to narrow your nostrils.  The reason is you would then not like how your nose looks at rest. I would recommend you consult with a facial plastic surgeon.  This way you can go over your concerns and what your goals with any surgical procedure would be.  If you like your nose at rest, then surgery can't improve soemthing that you like.  If there is something that bothers you about your nose, like mentioning the curve on the bridge of your nose, then surgery can help that.  I hope this helps and good luck.  

The flaring of your nostrils can be reduced by removing excess skin inside the nostrils at the base of your nose. Downward movement of the tip can be reduced by cutting a small muscle at the base of the nose. As you suggested you should consider removal of the small hump on your bridge.

Virtually everyone's nostrils flare when they smile and yours aren't particularly excessively flaring.  It is also normal for the tip of your nose to droop slightly when smiling.  When I look at your non-smiling photo, you have slightly wide nostrils and a tip that could be lifted slightly with surgery.  A Rhinoplasty can be performed on you which would lift the tip of your nose slightly, narrow the nostrils, straighten your septum to improve breathing and make any additional fine changes to the nasal bridge based on a good profile photo of your nose.