Will my smile come back? (Photo)

Question

The only thing that really scares me is that my smile has changed forever. When i smile i can feel the columella push my upper lip down, and my upper teeth are not completely visible. Could this be because of swelling? Or is it the columella placement? If so can this be reversed? I have rib cartilage in my nosetip and columella

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! If rib cartilage is used, there's always a risk of resistance with the excursion of the smile. Sometimes, this can be mitigated if the caudal aspect of the graft is made less prominent. As part of the pre-op discussion, if tip work is performed with rib cartilage, there's a risk of this happening that I always mention. If it's still within 1 year of your surgery, I would continue to give it time. If no resolution, then a revision may be necessary to trim the graft or replace it all together. Hope this helps!

Will my smile come back? (Photo)

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