When You Smile the World Smiles With You, After Rhinoplasty, Sometimes the World Smiles Alone
If you are happy with the results of your rhinoplasty, your smile should return very soon. Your "normal" smile may take a bit longer.
Often times during septo-rhinoplasty the muscle fibers between the base of the nose and the upper lip are separated to allow the tip of the nose to heal without being pulled downward.
This results in an upper lip that does not elevate properly, covering your gums and upper teeth when you smile. These muscle fibers usually grow back together within a few weeks, and your smile should return to normal at that time.
Be well and I hope that your smile returns to normal very soon.
Smile and numbness in rhino
In general, almost all noses are numb right after a rhinoplasty. In most cases its the tip that is numb, but this numbness can extend down to the upper lip, and in rare cases some of the teeth. There are nerves that are cut and stretched during a rhinoplasty, and it takes a long time for those nerves to start working again. This is true of an open as well as closed rhinoplasty, although it tends to be more extensive in open rhinoplasty. This could also be more extensive if a septoplasty is performed at the same time. A revision rhinoplasty is a much harder surgery with a lot of internal scarring to cut through. This can also be a reason for prolonged numbness. This, along with the swelling, gives you a stiff, plastic type feel, and can give you an odd smile. However, the nerves will start working and again, and your nose stiffness will go away with time. As the nerves grow back, you may feel some tingling, itchiness and on occasion pain. This takes in most cases months, but can take years in rare cases. Extremely rarely, the numbness is permanent, although I have never seen such as case.
Pablo Prichard, MD
Irregular smile after rhinoplasty is common and typically temporary
This is extremely common and there are a variety of reasons why this occurs which range from swelling, decreased sensation, wounds, etc. In most instances this resolves nearly completely. The time to resolution depends on the extent of surgery and can last from 3 weeks to 3 months
After rhinoplasty the upper lip can sometimes feel stiff and difficult to move as a result of swelling. Rhinoplasty always results in some degree of swelling as this normal healing, and swelling at the base of the nose can result in stiffness in the upper lip.
As the swelling improves the lip movement and sensation will return to normal. The likelihood of stiffness is dependent on the rhinoplasty surgery, revision surgery with multiple grafts are more likely to result in an increased degree of swelling and resulting stiffness. The symptoms improve in most people within a few weeks however rarely up to 6 months.
Changed Smile After Rhinoplasty Surgery
You do not mention when your surgery was done. It is normal to have swelling for several weeks after rhinoplasty. This will cause stiffness of the muscles of your upper lip and your cheeks, limiting their full range of motion. It is always transient.
Your smile should normalize 4 to 6 weeks after Rhinoplasty.
You can typically see difficulty elevating the center of your lip for a month or so after Rhinoplasty. I see this in most of my patients when I place a columella-strut (cartilage graft) for tip modification, and the stiff upper lip is usually short-lived.
Ask your doc if he placed a "C-strut". I'll bet he did, and your smile will likely be fine shortly.
I hope this helps, and enjoy your new nose.
Need more time for your lip function to improve
Swelling after a rhinoplasty is not uncommon and this can, at least temporarily, affect your smile. Given more time this will most likely improve on its own. Make your surgeon aware of your concerns and have confidence that over the next 6 months or so it will improve.
Don't worry, your smile will come back!
After rhinoplasty, a few things can happen which can affect your smile. If work was done at the base of your nose or at the bottom of the columella (skin bridge between the nostrils), swelling in the area can affect the lip and cause it to drop a bit temporarily. As the swelling resolves, which can take months, the lip will return to normal position. Sometime if extensive work is done in this area, the muscles responsible for pulling the uppper lip up are temporarily weakened, a condition which will also return to normal over months. If the problem does not get better by one year's time, you should be re-evaluated by your surgeon.
In some cases, a surgeon may place material between your nostrils in order to provide more support to the tip of the nose. Often this can be a cartailge graft which serves as a collumn to support the tip. A rare complication is this graft slipping forward and down toward the lip. Overall this is a very unusual situation, but if it does occur it can easily be corrected with a minor touch up procedure.
The other thing to keep in mind is that if the tip of the nose is brought up and elevated, it can make the upper lip appear longer. It should not cause the lip to actually drop down and cover your teeth more, however.
Often the smile is affected after a rhinoplasty near the lip. It will return to normal in 6-12 months. There is nothing to do to make it faster.
Smile typically comes back after Rhinoplasty.
In the initial few months after a cosmetic rhinoplasty many changes occur with regards to swelling, healing, and possible numbness.
As these initial concerns become less bothersome, and lessen one begins to see a return to normalcy overall. In the majority of the time, the smile also normalizes to how it was before the procedure.
I hope this helps, and best wishes on a successful result.
Sergio Pasquale Maggi, MD, FACS
Austin Plastic Surgery Center