My nose widens and points down when I smile. What procedure would help with this? (Photo)

Question

I try my best not to smile because my nostrils widen and the tip of my nose turns downward making it look flat on my face. I am really interested in doing cosmetic surgery to correct this. I would really like to do this under local anesthesia. I am verY nervous with General. I even convinced my dr to do my breat augmentation under local and that went really well. Is their a procedure that can be done under local? What would be the recovery process and a cost estimate?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question and photographs. You may have a plunging tip deformity.  There are several conservative changes which could be performed.   It is possible to cephalically rotate the tip with cartilage suturing, angled caudal septal trim, and columellar strut grafts.  In my practice, the best results from this surgery are performed under general anesthesia.  You will need to find a surgeon comfortable doing this procedure under local anesthesia, but I would personally caution against this.  The most important aspect is to find a surgeon who 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.

Ahmad N. Saad, MD, FACS · Answer

There are several options that can help with your condition. Can definitely be done under local anesthesia.

Jerome Edelstein, MD · Answer

Hello,Thank you for your question. There may be a few different options you have to correct what you have mentioned. Your Plastic Surgeon may recommend local or general anaesthetic depending on the complexity of surgery you plan for. You will find that costs vary as well depending on the degree of work to be done, between practices and locations. I recommend that you seek a board certified Plastic Surgeon who's before and after photos appeal to you. As them about their pricing.All the best

William Portuese, MD · Answer

To prevent the tip from drooping when smiling requires releasing of the depressor septi ligament. When this ligament is released, it prevents the tip from drooping with animation and smiling. To narrow wide nostrils requires excision of a wedge of skin at the base of the nostrils to narrow  them. Both of these procedures can be performed under local anesthesia as an outpatient surgical procedure. Further adjustments of the nasal tip cartilages and the bridge require general anesthesia for patient safety and comfort.

Neal Handel, MD · Answer

It is not uncommon for the nasal tip to
point downward when an individual smiles. This is especially true if the nose
is long. There are several ways that rhinoplasty can correct this problem. One
is by shortening the excessively long nose, usually done by trimming some of
the septal cartilage. It is also possible to detach the muscle between the
upper lip and the base of the nose that contributes to downward pulling – this
usually helps as well.

My nose widens and points down when I smile. What procedure would help with this? (Photo)

Answers (7)

Answer: Rhinoplasty to prevent the tip from drooping when smiling

Answer: Rhinoplasty to prevent the tip from drooping when smiling

Answer: Nose pointing south

Answer: Nose pointing south

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My nose widens and points down when I smile. What procedure would help with this? (Photo)

Answers (7)

Answer: Rhinoplasty to prevent the tip from drooping when smiling

Answer: Rhinoplasty to prevent the tip from drooping when smiling

Answer: Nose pointing south

Answer: Nose pointing south

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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.