Will my Nose Job Permanently Affect my Smile?

I just had rhinoplasty a week ago and today my surgeon removed the bandage, splint and stitches. I just tried smiling and realized that I can't smile. My upper lip stretches out and it looks really strange. I'm really, really worried. Will I be able to smile normally again? Will my smile look the same?

Doctor Answers 18

No, your smile will come back.

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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.
Best Wishes,
Pablo Prichard, MD

Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

One week is a moment in the lifetime

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At one week, your lip is swollen, your nose is swollen and your smile will feel unnatural, just as you have described. Relax and enjoy the good stuff to come!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Smile affected by nose job

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Hi MT,

It sounds like the muscles of your upper lip were freed up from the connections to the tip of your nose. This is the most common reason for the upper lip to hang down a little more than usual over your upper teeth, and also affect your smile following rhinoplasty.

We often times perform this maneuver during a Rhinoplasty when elevating the tip. By detaching the muscles, the tip of the nose is not pulled downward during the initial recovery period.

Fortunately, the effect on your smile should be temporary as the muscles reattach, and the normal function returns. In my patients it usually takes two to three weeks for the smile to return to normal. You should speak with your surgeon to find out exactly why your smile is different, and when you can expect it to return to normal.

Enjoy your new nose, and hopefully your old smile very soon. Be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Your smile will return after rhinoplasty

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It is quite common for the smile to be affected right after a Rhinoplasty.

There are muscles right beneath the tip of your nose that are sometimes affected by the surgery. In a few weeks, your smile will look more normal.

Facial Function Following Rhinoplasty

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Loss of animation of the upper lip following rhinoplasty surgery is usually always secondary to swelling. In some cases, detachment of the lip 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. 

Is a Smile Affected By Rhinoplasty

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After rhinoplasty, especially if there is septal work done, there can be some numbness and swelling in the upper central lip area which usually subsides in 6-8 weeks. This can temporarily effect the smile. It is not permanent even when one releases the depressor septi muscles for a short upper lip.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

It will probably be normal with time.

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As you are very early into your rhinoplasty, there will be a large about of swelling still present in the tip and nasal base for several weeks to come.  Just like a sprained ankle doesn't move well when it is swollen, neither does a nose.  As the swelling comes down the motion should normalize.  I agree with Dr. Persky that release of muscles at the base of the nose/upper lip region can affect your smile.  As long as the muscles were not resected and only freed up, they should scar back down into a similar position.  This should then result in fairly normal lip movement.

Be patient and good luck,

Dr. Shah



Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Not permanently.

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The smile will be very minimally affected for the first few weeks after the surgery because of the stiffness of the upper lip due to swelling from the rhinoplasty. This will subside within the first couple of weeks after the surgery and will not be a permanent problem. Full healing after the rhinoplasty procedure is one year,  so be patient with a healing process. For many examples, please see  the link below to our rhinoplasty photo  gallery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Try not to get overly worried at this point.

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During a rhinoplasty procedure, structures can be altered/changed that could affect a smile, and sometimes this is desirable and planned. Having said that, I think that most likely you are still having some swelling in the area and should wait for the initial swelling to go down--don't get overly worried at this point. Finally, when I perform an external (open) rhinoplasty, I advise my patients to refrain from too much smiling the first few weeks. Hope this helps!

Robert J. Chiu, MD
Pittsburgh Facial Plastic Surgeon

Heaviness of your upper lip with smiling may be expected after rhinoplasty, and typically resolves.

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When we use a columellar strut to enhance tip support, and help maintain tip position, the bottom of the strut is implanted down to the bone above your upper central teeth. The upper lip muscle may be spread to make a pocket, and temporary upper lip heaviness with smiling may occur. This is typically self-limited. Hope this helps.Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.