Will an Over-reduced Nose Cause a Lack of Support to the Upper Lip?

I had rhinoplasty 4 years ago and the doctor over resected removed my nasal spine and cut the depressor muscle. Ever since my upper lip feels very different, like there is nothing supporting it. My nasal tip moves very easily and has no support. I have an inverted V and a slight pinched tip. When I wear a breathe right strip, my nose and upper lip feel more natural and supported. I was wondering if I would get the same relief if I had a revision with spreader grafts.

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9 Doctor Answers | Asked by 11704 in Lindenhurst

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Absence of Nasal Support

Hi, Based on your description, it seems that you are a great candidate for a multifaceted corrective rhinoplasty. Columellar strut grafting will help with supporting your nasal tip that may require modifications depending on its current status. Spreader grafts will help with your breathing (recall that you feel best with breathe right strips) and will reflect aesthetically over the nose shape overall. Further modifications may be necessary depending on your facial features... more

Inadequate Nose Support

The result of inadequate tip support can typically result in a drop of the tip with resultant elongation of he upper lip. The goal in your case would likely be to address the fundamental problem, lack of tip support, with most likely a cartilage graft as a columellar strut, along with whatever else is indicated.

Over-reduced Nose

Over-reduction of supporting structures is the most common reason I do revision rhinoplasty. All the issues you have can be addressed by restoring support mechanisms with cartilage grafting from septal, ear or rib cartilage. A columellar strut graft can help alleviate a drooping or flaccid nasal tip. Lateral crural strut grafts can both support your breathing and help alleviate the look of a "pinched tip". Spreader grafts can both make your nose look... more

James C. Marotta, MD

9 reviews

Long Island Facial Plastic Surgeon

www.marottamd.com

Candidate for revision rhinoplasty

Based on your description you sound like a great candidate for revision rhinoplasty. Spreader grafts can help improve your airway, especially if you find relief with breathe-right strips. To support your tip, you likely need a columellar strut graft. If needed, your upper lip can be lifted through an internal approach at the same time. The inverted V deformity can also be improved at the time of the revision. In some cases a fascia graft can help correct this and provide an un-operated look.... more

Over treated nose?

It sounds like you have multiple issues going on. Without an exam it would be hard to suggest what can be done. Good luck.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Help For an Over-reduced Nose after Rhinoplasty

Your result is one of the reasons that most of us have changed the way we do rhinoplasty surgery. In the distant past, most rhinoplastys involved removal of quite a bit of tissue- bone, cartilage, soft tissue, and muscle.The problem with this type of surgery is exactly what you are experiencing- poor breathing, no tip support, and an unnatural, pinched appearance that develops over time. Current rhinoplasty dogma is to spare as much cartilage as possible which prevents these issues. You are... more

Wow what a dilemma

You have what revision rhinoplasty books are written about. These are popular problems that revision rhinoplasty specialists like myself see every day. We like to say they are hard to fix and they are for surgeons who dont do revisions... iIf you send me pictures I can give you a better evaluation...send photos to sarah at beverlyhillsbody.com my consultant who receives all the pictures

Will an Over-reduced Nose Cause a Lack of Support to the Upper Lip?

IMHO, it's the resected depressor muscle and anterior spine reduction that may have decreased upper lip support and or volume. Photos or an in person evaluation would be required for further evaluation. In these cases a crushed cartilage plumping graft, fillers to the area and/or upper lip augmentation might be suggested.

Over Reduced Nose

You're correct when your suggest that spreader grafts will improve your breathing and correct your inverted V deformity. It sounds like you need a columellar strut graft to support your tip. Grafts will also be necessary to correct the pinched tip. A revision to reconstruct your nose should be done by a experienced revision rhinoplasty specialist.