Nose Pushes Down when I Smile. Is This Hard to Fix?

Question

Thank you for answering my question..I need to ask if it hard correct the type of nose that pushes down when you smile..It is half corrected from the first nose job..I am more concerned about this than the tip...My photos dont even look like me and the point looks worse when it gets pushed down low in a smile.. Is this a tricky type of surgery..If it is I rather not even do it.

Toby Mayer, MD · Answer

If this is all that is the problem it is easily corrected usually under local anesthesia. It involves cutting the muscle that pulls the tip down, but may also need better tip support. See an experienced revision rhinoplasty surgeon to get the best result.

William Portuese, MD · Answer

When the nose dips down on animation, this is caused from the depressor septi muscle, which is located between the septum and the orbicularis oris muscle (the smiling muscle around the lips). Contraction of the orbicularis oris muscle pulls the tip down. Not everyone has this. At the time of the rhinoplasty procedure the depressor septi is separated from the orbicularis oris, so that the nose tip becomes static and not dynamic.

Parham Ganchi, PhD, MD · Answer

Sometimes the tip of the nose pulls down due to the pull of a small muscle.  If you are happy with the rest of your result, your surgeon may be able to cut this muscle in a small procedure under local anesthesia.  Speak with your surgeon about your concerns and see what he can do for you.  Good luck!

	Dr. Parham Ganchi

Michael A. Jazayeri, MD · Answer

The problem you are describing is usually (but not always) related to strong muscles at the base of the nose which pull the nose down during smiling.

	If this is the only reason your tip is pulled down, the muscle can be divided under local anesthesia with oral Valium or similar medication.

Steven Wallach, MD · Answer

Pulling down of the nose may be caused by poor tip support or strong muscle that depress the tip. Sometimes these muscles need to be cut to release the tip.

Olivia Hutchinson, MD · Answer

The tip of the nose is often pulled downward when smiling due to facial muscles acting on the end of the nose. Since you have already had surgery, you should speak with your surgeon about what has already been done in the first rhinoplasty and which options are still available in any revision.

Darryl J. Blinski, MD · Answer

Without photos and an in person details examination I guess your issue could be addressed in a minor operation. But you need opinions in person. From MIAMI DR. B

Richard W. Fleming, MD (retired) · Answer

There are two possible reasons why your tip droops when smiling: 1) You lack tip support which can be improved with the placement of a columellar cartilage graft or 2) interrupting a small muscle, called the depressor septi, at he base of the nose. This can be easily done under local anesthesia.

Nose Pushes Down when I Smile. Is This Hard to Fix?

Answers (8)