Can a rhinoplasty and a bullhorn lip lift be done simultaneously? If not, which procedure should be done first for best results?

Question

1) Can a rhinoplasty and a bullhorn lip lift be performed at the same time? If not, which procedure should be done first? My concern is if I get a bullhorn lip lift and then subsequently have the base of my nose (i.e., the width of my nostrils) narrowed, the lip lift scar may become more prominent. 2) If done simultaneously, is there an increased chance of scarring? Would it lead to less accurate results, like an off-center philtrum? Thank you in advance for any insight you provide.

Philip S. Schoenfeld, MD, FACS · Answer

Your questions and concerns with regards to lip lift and rhinoplasty are excellent.  I concur in that doing the procedure simultaneously would likely lead to prolonged healing and potential complications from too much surgical manipulation of the base of your nose with potential for compromised blood supply and loss of tissue.  I would suggest starting with your rhinoplasty for a few reasons.  One of them is that your lip may change slightly following your rhinoplasty and if you decided to undertake the lip lift at a later date, you may have to elevate the lip more or less depending upon the surgical result of your rhinoplasty.  The other reason is to decrease the variables of healing and surgical manipulation of a delicate and somewhat unforgiving area of your face.

Gary M. Horndeski, MD · Answer

Hi, Great question!This is where skill and experience come into play in planning and successful execution of both procedures done simultaneously. I've never had a problem with combining these two procedures. Typically, the rhinoplasty is executed before the lip lift to ensure proper spacing and tension between base of nose and top of lift. I hope this helps.Best wishes and kind regards,Gary Horndeski M.D.

Ira D. Papel, MD · Answer

These are two very distinct procedures done for different reasons. Your particular needs and anatomy would be very important in determining if your proposed double procedure is appropriate or not. If you require an open rhinoplasty doing the lip lift might endanger the blood supply to the skin on the columella part of the noose. An intranasal rhinoplasty would not affect the skin as much, if at all. Only an in-person consultation is likely to give you the answer you are seeking.

Emmanuel Mallol Cotes, MD · Answer

Thanks for sharing your concerns with us. My recommendation for you is to send your photos to tell what kind of procedure you need.Respectfully, Dr. Emmanuel Mallol.-

Jason Roth, MBBS, FRACS · Answer

I would not recommend doing both procedures at the same time. The risk is that the incision lines for the rhinoplasty and the lip lift are on either side of a small patch of skin called the columella. This patch of skin will have it's main blood supply cut off on either side and is at a slight risk of dying off and leaving a scar. Generally we recommend doing the rhinoplasty first and the lip lift 2 to 3 months later.

Andrew Kornstein, MD, FACS · Answer

The short answer is "yes", they can be performed together.Your inquiry about alaplasty(nostril narrowing) is a good one, but nostril narrowing is not part of all rhinoplasties and certain nasal base/nostril issues can be performed with an internal(nostril) incisionThe more important question is do you truly need a lip lift or is your nose actually over rotated(too turned up),also, is your paranasal (just to the sides of the nasal base) depressed?Hope this helps

Barry L. Eppley, MD, DMD · Answer

An open rhinoplasty and a subnasal lip lift should not be performed together. Placing two incisions that close together carries risk of potential wound healing complications. The rhinoplasty should be performed first. That outcome may affect whether and how the subnasal lip lift is done.

Steven Wallach, MD · Answer

It might be safest to stage the two.  It really depends upon how the nose is done. A closed rhinoplasty should have little to no impact on likely doing them together in the average healthy patient.

Richard W. Fleming, MD (retired) · Answer

As long as the closed rhinoplasty technique is used both procedures can be done at the same time. Obviously you want an experienced rhinoplasty specialist.

Can a rhinoplasty and a bullhorn lip lift be done simultaneously? If not, which procedure should be done first for best results?

Answers (9)

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