What procedure can fix enlarged nostrils after a bullhorn lip lift? (Photos)

It's sad to see your situation, my honest sympathy be with you, apart from your psychological distress because we're facing here a formidable enemy. Your resection has been so aggressive that it's pulling down your columella, your tip and the alae, besides almost merging upper lip and nose.

I'll speculate here what lead to your situation, 2 options not incompatible to each other; either:
-you were not at a candidate for an indirect lip lift aka "bullhorn lift) (do not confuse with the direct lip lift) for having short distance between upper lip and nose, hence the over rotated upper lip you show now and the tiny length of your philtrum (distance nose-lip)
-your surgeon miscalculated and over resected the skin at the nasal base

Or both; in any case, there is an evident over tension at the closure that is not due to genetical factors, it is a dehiscence due to mechanical strain, and this has bad solution; it'd be raising a pair of nasolabial flaps to restore the missing portion at the nasal base, not even skin grafting would be acceptable due to its poor aesthetic outcome for this specific purpose, it has to be nasolabial flaps.

Stay far from chemical peels, lasers, injections, etc, that is all wishful (surgical) thinking.

You need a "reconstruction" of the philtrum, restoring part if not all the tissue resected by the surgeon, and this entails additional visible scars, but I do encourage you to go for it given your age, your affection and the objectively bad result you got.

Most lip lifts at young ages are unwise, I am a practitioner of this technique on aging patients, trans women and some very specific and peculiar younger patients' situations, and never large or aggresive resection, better stay short and repeat if needed than really large or better said aggressive amount of indirect lip lift; better stay cautious, this is a de facto irreversible or non-easy-to-revert maneuver leading to very explicit and obscene scars, eventually might not pay off for the potential benefit.

Generally, scars start to gradually improve around three months after surgery. Over time, they continue to fade and eventually remain as fine, white lines.
It seems that the scar resulting from the philtrum reduction is causing you significant concern. If alar reduction is performed during the rhinoplasty, the area of the current scar will need to be re-incised, which will create a new scar. Depending on the surgeon’s technique, the size of the new scar can be minimized.
After surgery, it is important for the patient to follow proper aftercare to help the scar gradually fade. Scar maturation typically takes about 6 to 12 months, so improvement will occur gradually over time.

Based on what I see, you appear to have visible scarring after your lip lift. There is also excessive nostril show. Since we do not have experience with lip lifting, I am not sure if the feasibility of trying to revise your scars. If you are looking to achieve less nostril show, microdroplet Silikon-1000 nasal injections may be considered for lowering nostril margins for decreased visibility of the inside of your nose. I hope this helps. Sincerely, Dr Joseph

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

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