Nasolabial angle and upper lip after rhinoplasty (Photo)

Question

I’ve had septorhinoplasty 3 months ago. My nose was deprojected, hump removed. Now I have a horizontal line under the nose when I smile, it’s just skin folding it’s not because of graft. Also, red part of my upper lip is smaller which can be seen from side view. It’s more droopy Also when I smile, it doesn’t flatten (from side view) as before. Before procedure, I remember I had prominent bone at the base of the nose under columella. It’s completely removed. What could cause all these changes?

Eric M. Joseph, MD · Answer

When nasal deprojection is performed, sometimes the dissection goes all the way down to the bone, through the upper lip musculature. It may be many months until your upper lip regains full mobility. If the horizontal crease was not there preoperatively, I believe that may improve as well. Wishing you while moving forward. Sincerely, Dr Joseph

Gary M. Horndeski, MD · Answer

The rhinoplasty changed the bottom skin between your nose and upper lip. You have more skin there and that is why the fold is occurring. You may benefit from a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. At three months that can still be due to swelling. If it doesn’t resolve by six months, you may want to consider making sure it is not the base of a columellar strut graft which can easily be trimmed under local anesthesia if needed. I recommend that you maintain close follow up with your rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Mats Hagstrom, MD (license on probation) · Answer

I don’t think there’s much your surgeon can do regarding your concerns over what your lip looks like when you smile.
It looks like the rhinoplasty turned out well.
Best,
Mats Hagstrom MD.

Nasolabial angle and upper lip after rhinoplasty (Photo)

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