Smiling may cause some slight and temporary modifications in the shape of the nose which are a benign form of nasal flaring. The nose and nostrils may widen, or the tip of the nose may point downward and droop. While overall liking their nose, sometimes patients are self-conscious about this specific issue when smiling and complain about it during consultation in the hope of finding a remedy.
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What causes the wide or droopy nose when smiling?
Everyone experiences at least a subtle modification in their nose appearance when smiling: you can feel it by yourself by placing your index finger on the side of your nose right where the opening of the nostril and the cheek meet and then forcing a smile; you will feel your finger being slightly pulled to the side of your face. Likewise, when placing the index finger at the base of the septum (base of the columella) and smiling you will feel it being pulled down towards your lips. In some individuals this may become more evident: not all smiles are the same and we all have slight anatomical differences.
- We activate the mimic (expression) muscles to a different extent.
- We also may use different muscles
- We have different muscle anatomy
- We have different nose and face anatomy.
Moreover, not everyone is self-conscious and bothered by this slight movements hence only some seek a solution to this.
In some cases, the unwanted nostril flare may also be due to a rhinoplasty. If the surgeon modifies the size of the nose, making it smaller, without reshaping the nostrils as well to make them proportionate to the new nose, you may have flared nostrils as a result. This can also happen if the rhinoplasty modifies the position of the tip of the nose in relation to the base of the septum: if pulled back it could modify the look of the alar base which then gets exacerbated by the smiling motion.
How to fix nostril flaring when smiling?
There are both surgical and nonsurgical options to fix the widened nose or the elongated nose with droopy tip when smiling.
Non-surgical option: Botox or Dysport
Botulinum toxin is the only non-surgical option available to address this issue. Being caused by muscle contraction, injecting a few units in strategic points of the face will reduce both the widening of the nose and the droopy tip when smiling. It is very important to have the injections performed by an experienced provider as if done wrong this could temporarily compromise your smile and expressivity in general. Injection site and volume have to be carefully planned after analyzing your face and smile.
This is a temporary fix, and the treatment will have to be repeated 2-4 times a year to be effective all year round. It won’t be very expensive as only few units are required to obtain the results and there will be no downtime from this procedure.
Botox won’t work if the nostrils are flared or if the tip is droopy also when not smiling: in this cases the only way to address the issue is with surgery.
Surgical options for wide nose when smiling and droopy nasal tip
There are several different surgical procedures that may help address the wide nose and the droopy nasal tip when smiling. You should discuss the following options with an experienced facial plastic surgeon.
Flared Nostril Rhinoplasty
Flared nostril rhinoplasty is a procedure that surgically weakens the muscles that pull the tip of the nose downwards and the nostrils laterally when we smile. The muscles are accessed through a small incision at the base of the columella and are slightly trimmed to reduce their pulling force. Unlike Botox, the effects of this surgery are permanent. Flared nostril rhinoplasty in some cases may also improve the look of flared nostrils at rest.
Tip Rhinoplasty
Reshaping or shortening the tip of the nose may fix both the widening and droopy nose when smiling. The tip may be responsible for curved round nostrils that can be straightened surgically or may present excess cartilage causing the droopy look. For this reason, addressing the tip may improve the look both at rest and when you smile.
Alar Base Reduction
Alar base reduction reduces the size of the nostrils by removing a small wedge of tissue. Surgery is performed by making a small incision inside the nostrils, known as Weir incision. This surgery addresses the size of the nostrils both at rest and when smiling. The scar resulting from the incision is usually unnoticeable.
Takeaway
Flared nostrils, widened nose and droopy tip when smiling are all issues that can be fixed.
With the nonsurgical option, costs are lower than a traditional Botox treatment as only few units are required, and the benefit is that it is reversible and there is no downtime.
With the surgical options there is little downtime, and they are often performed as outpatient procedures. Costs are lower than a traditional rhinoplasty.
It is very important to have a consultation with an experienced facial plastic surgeon to avoid complications, botched results and dissatisfaction.
Sources
- Multifactorial approaches for correction of the drooping tip of a long nose in East asians.
SG Park, H Jeong – Archives of Plastic Surgery, Nov 2014 - Nostril Surgery: Indications, Surgical Procedures and Outcomes-A Systematic Review of Published Cases.
S Gandolfi, J Laloze – Aesthetic Plastic Sugery, Dec 2020 - Global 3-dimensional approach to natural rejuvenation: recommendations for perioral, nose, and ear rejuvenation.
V Gassia, H Raspaldo – Journal of Cosmetic Dermatology, Jun 2013 - Non-surgical rhinoplasty using filler, Botox, and thread remodeling: Retro analysis of 332 cases.
Y Helmi – Journal of Cosmetic and Laser Therapy, Mar 2018
