Unable to Smile Propely at Almost 7 Weeks After Rhinoplasty

I read your concern:

Nearly all of my Rhinoplasty patients have temporary heaviness of their upper lip when smiling. I place a columella-strut in nearly all of my patients: this type of cartilage graft is used to support your tip, and the bottom of it lives in the muscle of your upper lip. This results in some difficulty smiling for 6-8 weeks following rhinoplasty surgery. This has not been permanent or problematic in any of my patients.

Good luck with your healing.

I hope this is helpful for you.

Regards from NJ.

It is extremely common for the upper lip and smile to be affected for months after rhinoplasty due to stiffness and swelling in the base of the nose

Hi,

This is not an uncommon concern following a rhinoplasty. In fact, I usually tell my rhinoplasty patients that their smile will not feel the same for at least the first 3 months after the surgery. This is due to a combination of post-operative swelling and dissection around the columella, as well as dissection along the junction of the nose and lip. Believe it or not, patients tend to have some swelling even months out after surgery. As you mentioned, you have already started to see a change with more visibility of your teeth as the swelling starts to dissipate. It will likely only be a matter of time before you start seeing even more of an improvement. Good luck!

Dr.Sunder

Hi Beatriz,

Keep an upper lip about this.  Your surgeon knows best.  It will likely take a few more weeks for your upper lip muscles to reattach and for your smile to return.  Good luck and be well, hope that you enjoy your new nose.

Dr. P

You should expect some (usually very minor) changes in the upper lip as de-rotation of the nose can relieve tension in that area.  As the nasolabial angle changes to a less obtuse position, the lip can drop very slightly.  In most patients, this is not noticeable, however, in some it can be seen.  This is usually accentuated by the swelling in this area immediately after surgery.

As with all rhinoplasty, healing time is expected in order to allow for the swelling to resolve.  As the swelling and firmness fade, you may still notice some difference, but this should not stop you from accepting and enjoying your new nose if your surgeon has achieved your goals.

Of course, you should also address this with your surgeon, as he/she will be able to further explain precisely what was done. 

In agreement with other responders, healing, resolution of swelling, softening of stiff tissues, and return of neuromuscular function after surgery are processes that occur gradually,  You understand this intuitively, as you mention that your upper lip lifts more than it did immediately following your procedure, but still not normally.  So you see, nobody can predict the future, and tell you the precise number of weeks until lip elevation is normal.  It is not  a problem that persists for a number of weeks, and then instantly resolves.  Every patient and situation is different.  You should see slow, steady improvement as time passes.

It is difficult to render a professional opinion without examining your nose or having a picture to visualize it. Based on your descriptions, there remains some degree of swelling in your upper lip after your recent rhinoplasty and upper lip surgery. I would recommend you to wait for at least two months until majority of swelling has subsided, then if there is any issue with you upper lip and smiling, then talk to your rhinoplasty surgeon.  Good luck and good healing. Dr. Kevin Sadati

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. 

You have had a great deal of work done at the lip tip junction. Healing is a variable thing. I can't tell you how long but, just wait this should clear up.

I'd give yourself 3-6 months for your smile to return to normal.  If the plastic and cosmetic surgeon dissected the tissues in front of the columella, this can weaken the nerve that raises the upper lip.  Most of the time this returns to normal function within a year following the Rhinoplasty.  IMHO, I would not consider any treatment or surgery until that year has elapsed.