Why does upper droopy lip accrue after some rhinoplasty or revision rhinoplasty surgeries?

Why upper droopy lip accrues after some rhinoplasty or revision rhinoplasty surgeries? Is it because the surgeon actually cut some muscles or nerves in that area, or is it just an illusion caused by an extensive shortening or rotation of the nose? Can caudal extension grafts or any other grafts in that area cause some upper lip droopiness? How can I be sure that after my revision rhinoplasty I will not suffer from this problem? What should a doctor do in order to prevent it? Thanks in advance!

Doctor Answers 2

Revision rhinoplasty candidate

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 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.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Rhinoplasty and the upper lip

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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.

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

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