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

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.

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

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

 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.

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.

Thank you for the question and a rhinoplasty done by an expert in the area should give you the desired result.  So go on some consults and become informed what can be done and compare fees.Dr. Corbin

You have a condition that is very easily corrected by a safe simple procedure that can be done under local with sedation. The procedure should be performed by a very experienced surgeon to make sure that you have no outside incisions, no visible scars, no pain, and no packing. You should have a very short recovery period. Good luck!