My nose looks too wide when I smile, what are my options? (Photos)

Question

Hi! I like my nose generally when I’m not smiling (the bottom could be a little smaller though), but when I smile, I feel like it gets very wide and the bottom under part gets lower. Is there a good way to fix this? I’m scared that rhinoplasty would be too dramatic!

Brock Ridenour, MD · Answer

Everybody has some flaring of the nostrils when smiling or laughing, however, flaring can be more pronounced in some individuals.  Rhinoplasty works best for static flaring of the nostrils (flaring that you see at rest). Surgery can reduce the circumference and overall size of the nostril and allow the nostrils to appear less curved and narrower at rest. 
Excessive flaring of the nostrils that is present only when smiling can be treated with more conservative measures such as Botox. There are muscles that pull the nasal tip down and pull the nostrils laterally. By injecting a few units of Botox into specific areas around the nose, the pull of these muscles will be softened, reducing the nostril flare. Each injection requires just one, two or three units of Botox, making this option very affordable. Botox is not permanent and does need to be repeated twice or three times a year to maintain the result. I hope this helps. Best.

Ali Sajjadian, MD, FACS · Answer

Thanks for your question . Rhinoplasty is the particular surgical operation that can solve your worry regarding the lower portion of your nose dropping and expanding while you grin. 
How Rhinoplasty Can Be Beneficial
Alar Base Reduction: By narrowing the base of your nostrils, this operation might make your nose appear smaller when you smile.   
Tip Refinement: This can raise the tip of your nose so that when you smile, it doesn't droop or seem lower.   
Cartilage Grafting: To support the nasal tip and preserve its form during facial expressions, cartilage transplants may be utilized in certain situations.  
 Speaking with a Board-Certified Plastic Surgeon about your unique concerns and objectives is essential. They are able to evaluate your facial shape and suggest the best course of action.
 Hope this was helpful!
Best wishes,
Dr Ali Sajjadian 
TRIPLE Board Certified Plastic Surgeon

Jeffrey Lisiecki, MD · Answer

Great question!  For nostrils that flare, an alar base reduction or alarplasty can be done without a rhinoplasty (if you're happy with the rest of your nose).  Sometimes Botox can help flaring nostrils and a drooping tip a little bit as well, but of course it is temporary and needs to be repeated.  To really fix a drooping tip, though, rhinoplasty is the answer!  Rhinoplasty can be done very subtly and conservatively if you like the rest of your nose; you may be a good candidate for a tip-only rhinoplasty to fix the drooping and flared nostrils without breaking your bones or changing the upper 2/3 of your nose.

Thomas Buonassisi, MD · Answer

It's common for individuals to notice changes in their facial features, including the nose, when they smile. Many people feel that their noses can appear wider or more prominent during expressions, and this can be due to the way facial muscles and skin move. If you're looking for a less dramatic approach than rhinoplasty, consider options like non-surgical nose reshaping using dermal fillers. This can subtly enhance the contours of your nose and improve balance without the commitment of surgery. It’s always a good idea to consult with a qualified professional who can discuss your concerns and provide personalized recommendations.

Andrew Miller, MD · Answer

While there are muscles that pull the nose out wider during smiling, if the nasal tip doesn't have great support, then this effect becomes even more pronounced. A well performed rhinoplasty can refine and strengthen your tip without looking too dramatic. A stronger tip won't spread as much. If you don't want surgery, then a little botox can help some. Be sure to see a facial specialist for consultation.

Sirius K. Yoo, MD · Answer

Thank you for your question.  To treat your concern, you would likely need some form of rhinoplasty.  Rhinoplasty can be very subtle or dramatic depending on the desired changes.  When it is well done, it should look natural and harmonize with the rest of your facial features.  Its normal for the nose to get a little wider when your smile. This is because the cheeks pull back on the tip and nostrils.  If the tip does not have adequate support, it cannot resist this pull and the nose widens significantly.  If it is strong, you will notice limited widening.  So, treatment may be as simple as strengthening the support of the tip or it could require narrowing the tip and nostrils a little.  A rhinoplasty specialist should be able to give you more detailed advice after examining your nose.  All the best!

William Franckle, MD, FACS · Answer

Hello, and thank you for your questions. Although your photos are very helpful only a full in-person consultation assessing the entire nose can correctly diagnose your issues. The goal of a rhinoplasty is to create an aesthetically balanced nose where the tip, in relation to the dorsal (bridge) and the width (at its base), are all in harmony.  Other parts of the face, such as the length of the upper lip and projection of the chin can affect the overall appearance of the nasal size.
Nostril size is a common complaint amongst rhinoplasty patients. Generally speaking, if the nostril flair is too wide that can sometimes be corrected by removal of some tissue at the base (where the nostril attaches to the lip). Modification of the shape or size of the nostrils can often satisfy the overall aesthetic of the nose.
Visit with a board certified plastic surgeon to learn what is best for your aesthetic goals. At my practice we utilize 3D Imaging at a patient's consultation. You no longer have to rely on your imagination because we can show you, before you leave your consultation, what your expected results may look like with this imaging. Best of luck to you!

Evan Ransom, MD, FACS · Answer

Thank you for the photos and your question. Your nose seems to have a nice shape currently, though I agree that the bottom third is a bit wide. This is exaggerated when you smile because the cheek muscles pull up and out on the nose and mouth. A conservative volumetric reduction in the tip and a slight rotation can help with this. Unfortunately non-surgical options are not useful for your situation. Take care and best of luck!

Suleyman Tas, MD, FEBOPRAS · Answer

Hello, thank you for your question and provided photos, more photos would be helpfull as well.  A Rhinoplasty can improve a nose for natural, well balanced and proportioned by Closed and Atraumatic technique you are provided maximal healing, minimal edema&swelling and prevented tissue damage, scar on your columella.Regards,

Tarek V. Copty, MD, FACS · Answer

Hi Ginny, 
You seem to be a good candidate for a Rhinoplasty. I suggest you search for a plastic surgeon that has before and after pictures that you find similar to what your expectations are. Based on your pictures it seems you are a straight forward rhinoplasty candidate.
 Nose Jobs also known as Rhinoplasty is a wonderful operation that reshapes the nose and opens up the nasal breathing channels if they are blocked. 
The most beautiful aspect of this surgery is that once the nose is made smaller and symmetrical, the entire facial features are remarkably improved. 
Rhinoplasty requires technical accuracy, meticulousness and finesse. 
During your consultation review  plenty of 'before and after' pictures and that will give you an idea of your preferences and ensure you and your surgeon are on the same page. You can also do 3D imaging so as to see what your nose will look like after the surgery. 
The surgery takes about one a half hours and you'll be able to go home soon after that. There is minimal pain associated with this operation, but swelling and bruising for one week afterwards is expected. 
Best Regards, 
Tarek V. Copty, MD FACS
American Board of Surgery American Board of Cosmetic Surgery Jordanian Board of Plastic & Reconstructive Surgery Fellow, American College of SurgeonsFellow, American Academy of Cosmetic Surgery Fellow, International Society of Aesthetic Plastic Surgeons

My nose looks too wide when I smile, what are my options? (Photos)

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