One Year After Rhinoplasty and my Smile Has Not Returned. Can This Be Fixed? (photo)

Question

I have read up on rhinoplasty procedures and was originally not too worried my smile had not returned. I have been patiently waiting; however it has been almost 13 months since my procedure. It is a noticeable difference to me and bothers me daily. The tops of my teeth are still covered with my lip when I smile normally. I look at pictures before and my smile was much prettier. Is there anything I can do?

Kenneth Hughes, MD · Answer

The nasal depressor septi has considerable anatomic variability and its interdigitations with the tip, septum, and orbicularis oris can be complex. It may be possible to reattach the muscular elements through an intranasal or intraoral approach.

Babak Azizzadeh, MD · Answer

What you are describing has been known be helped by releasing the depressor septi nasi muscle. It's a good idea to speak with an experienced facial plastic surgeon about this. Following another six to twelve months, your smile should return back to normal.

Ronald J. Edelson, MD · Answer

In many cases, removal of a bump on the bridge of the nose can cause the upper lip to lengthen slightly. In most cases, this is actually a desired effect of the surgery. From your photos, I would not recommend any further surgery to try to reverse it. It looks like you ave a nice result.

Nima Shemirani, MD · Answer

Dear photjunkie2013,

	
		Do you feel anything that is preventing you from smiling?
	
		Sometimes we place grafts in the columella that can temporarily change the smile, but usually you see a crease just under the nose
	
		You should bring it up to your surgeon where you can have an exam


	Best regards,

	Nima Shemirani

Gary R. Culbertson, MD · Answer

The effect that is noticed before your rhinoplasty is called buccal or labial show. This is where your see the mucosa or lining over your teeth when you smile. This can commonly occur with patients with very large noses. The nose actually pulls on the upper lip causing it to raise up as a patient smiles showing the gums of the teeth. It is not normally considered aesthetically pleasing. Most patients desire significant buccal show with smiling to be corrected.
	 Your smile after surgery in my option is much more appealing than before. You could shorten your upper lip but, this could leave a significant scar just below your nostrils. Consider addressing your concerns with your surgeon at your next visit. Best,

	 

	 

	Gary R Culbertson, MD, FACS

One Year After Rhinoplasty and my Smile Has Not Returned. Can This Be Fixed? (photo)

Answers (5)