In our practice, we have been performing revision rhinoplasty for over 25 years and have never seen a droopy lip after the rhinoplasty or revision rhinoplasty. To prevent the tip from drooping when smiling requires releasing of the oppressor septi ligament at the base of the nose. That does not cause any droopiness of the upper lip.
Rhinoplasty is a surgery to change the shape of the nose for breathing or appearance.When the bottom of the nose is changed in rhinoplasty it may affect the upper lip. Lengthening the nose and using caudal septal extension grafts may push the bottom of the nose down toward the lip. Patients who have a smile where the corners of the mouth go up or patients who have a horizontal crease when they smile are both prone to feeling this change more than others. Before surgery, I photograph the patient's smile and talk about their potential for changes to the base of their nose. Using this information, I clearly communicate to my patients regarding the risk of a change to the upper lip or smile. Safety comes first.