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.

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
5.0 out of 5 stars 45 reviews

One week is a moment in the lifetime

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 32 reviews

Smile affected by nose job

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 36 reviews

Your smile will return after rhinoplasty


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

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. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 193 reviews

Is a Smile Affected By Rhinoplasty

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
4.9 out of 5 stars 58 reviews

Try not to get overly worried at this point.

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
5.0 out of 5 stars 6 reviews

Rhinoplasty and change in smile

It is not unusual for someone's smile to be temporarily affected after rhionplasty because of swelling in the central portion of the lip.  This is especially true if attachments of muscles to the septum and tip were disrupted.  This will typically improve over the course of the first few weeks as the majority of the swelling abates.

Sirius K. Yoo, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

Nose Job Implications on Your Smile

Considering that you are only one week into your recovery, it is extremely early to judge the results of your rhinoplasty. Your new nose can take up to a year to completely heal, during which time swelling will likely affect your surrounding facial features. It is understandable that you are worried about your smile, but you should rest assured that your smile will not be changed as a result of your nose job. Once the majority of your swelling has gone down in the coming months, you will be able to resume smiling naturally. 

Sam Rizk, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 71 reviews

It will probably be normal with time.


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 52 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.