How to Fix Bad Results from Bullhorn Upper Lip Lift?

Question

Years ago, I had a Rhinoplasty and was very happy with the results. Then  I had a bullhorn upper Lip lift a year ago. Now my lip to nose ratio has improved but I have a new problem, my nostils are HUGE.  My columella now hangs much lower than my outer nostrils.I look as though I am always sniffing something AND now the skin between my upper lip and columella puffs out like an ape. I have to fix this!! What should I do?

Jed H. Horowitz, MD, FACS · Answer

Good day! It is difficult to assess without an in person examination or at least a photo. Find a board-certified surgeon in your area and have it checked. Best of luck! #RealSelf100

Ricardo L. Rodriguez, MD · Answer

I have not have that problem.
My technique is to use a deep layer of permanent sutures fixing the stiff membrane surrounding the cartilage (perichondrium) and bone (periosteum) to the dermis (under layer of skin).
I only proceed to suture the skin once the lip skin is kissing the nose skin, and I ask the patient to purse the lips to make sure the fix is stable.
If you only excise skin then suture the skin edges together, they will eventually settle somewhere towards the middle. I suspect this may have happened in your case and theanswer is deep fixation sutures.
Check out my video on lip lift.

Otto Joseph Placik, MD · Answer

This is a confusing problem and I am not sure that there is an easy fix. Examination is clearly required. There are options but some may involve more scars or risk.

How to Fix Bad Results from Bullhorn Upper Lip Lift?

Answers (3)