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Rhinoplasty: Cutting Upper Lip Muscle

For nose lengthening surgery in addition to tip grafting for sharper more projected tip,is it necessary to cut the upper lip muscle? I was always of the impression that if the tip support is done well surgically, and ti p grafts secured in place, there should be no need for it. What is it's purpose

Doctor Answers (5)

Upper lip muscle considerations

+1

Occasionally the depressor needs to be released to correct some abnormalities about the tip, but it is by no means done routinely, as you have noted a well done tip and tip grafting when appropriate are more important.


Dallas Plastic Surgeon
5.0 out of 5 stars 2 reviews

Muscle

+1

I cut the depressor muscles of the nasal tip when i get a history of the tip drooping when the patient smiles. however, this should not be done unless tip support has been treated.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Upper lip muscle

+1

If a closed rhinoplasty is performed it is common to cut the membranous septum down to the maxilla.This incision will cut the orbicularis attachements to the septum. It is a technical detail that is not something that should concern you.I would focus on the quality of your surgeon.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 9 reviews

Cutting upper lip muscles

+1

In general no musculature is cut during rhinoplasty.  There are some cases where the nasal tip depresses with lip animation and the depressor septi muscle is treated to decrease this problem.  Donald R. Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

A gummy smile and droopy nose - how can it be fixed?

+1

There are many tiny muscles that can alter the shape of the nose and upper lip, especially during animation (i.e. when talking, laughing, or smiling.) There's one pesky muscle in particular, the "depressor septi nasi," that may need to be weakened, moved, or cut during rhinoplasty surgery.  "An active depressor septi muscle can accentuate a drooping nasal tip and shorten the upper lip on animation," concludes one important study published in 2000. This basically means that when smiling or laughing, the tip of the nose is pulled downwards, curving the nose like a bird's beak, and at the same time the upper lip can be pulled upwards giving a gummy smile. Cutting the muscle reduces or eliminates these undesirable distortions of the nose and lip. It is true that good tip support is always important to maintain tip shape and projection; however an overactive depressor muscle can still pull it downwards. Not everyone needs to have it cut or moved, but a good (board certified) plastic surgeon will be able to decide if this will help you!

Ariel N. Rad, MD, PhD
Baltimore Plastic Surgeon
5.0 out of 5 stars 26 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.