How Long Before Smile Returns to Normal After Rhinoplasty?

Question

I am a post-op for Rhinoplasty. I've been recovering pretty quickly and I haven't been having any problems really, other than this: I've noticed that after my surgery, my smile changed. Now, whenever I smile, my top lip doesn't go up as much as it use to and the top teeth barely show. My smile looks not only forced but very, very strange. Why is it like this, is it normal? If so, how long before my smile returns to normal?

Michael A. Persky, MD · Answer

Hi Perky,
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.
Dr. P

Richard J. Bruneteau, MD · Answer

Loss of animation of the upper lip following rhinoplasty surgery is usually always secondary to swelling.  In some cases, detachment of the tip muscles from the distal nasal septum may also contribute to this problem.
            In the majority of cases, function returns within a week following surgery.  In cases where the muscle attachments are divided, it may take as long as four to six weeks.
  
            It’s important to be patient and maintain good communication with your surgeon.  Your surgeon should be able to reassure you and ultimately make this a good experience.

Miguel Delgado, MD · Answer

Your smile can be affected
by swelling or bruising of the lips which can be common after a rhinoplasty.
After the swelling and bruising is gone, your smile will return to normal.

C. Spencer Cochran, MD · Answer

It is very common for rhinoplasty patients to report (in the first several weeks after surgery) that their upper lip feels stiff and that it is difficult for them to smile. Fortunately, this resolves by itself in the first several weeks after surgery as the swelling subsides. Be patient, your smile should return to normal.

Otto Joseph Placik, MD · Answer

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

Eric M. Joseph, MD · Answer

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.

David W. Kim, MD · Answer

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.

Toby Mayer, MD · Answer

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.

David Mattos, MD · Answer

Great question. This happens to most rhinoplasty patients because of swelling, healing, pain, etc. all caused by the rhinoplasty operation. This will all normalize in time, but may take 2-3 months for some patients. It always goes away and is not something to worry about. 
-Dr. David Mattos, New York Plastic Surgical Group

Sergio Pasquale Maggi, MD, FACS · Answer

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, FACSAustin Plastic Surgery Center