I've had five rhinoplasties - Would it be safe for me to undergo a lip lift at some point? (Photos)

Question

Good afternoon, I hope this message finds you well. I’ve previously undergone rhinoplasty five times—four closed rhinoplasties and one open procedure. In one of my surgeries, my surgeon attempted a tip plasty using cartilage from my ear inserted into a silicone implant. Unfortunately, the skin on my nose did not close properly, and the tip of the silicone implant had to be trimmed, resulting in a less-than-ideal outcome. In the future, I am considering a revision rhinoplasty using rib cartilage. However, I’m also very interested in having a lip lift. My main concern is the safety of combining these two procedures, given my surgical history. Would it be safe for me to undergo a lip lift at some point? Could this increase my risk for complications like nasal tip necrosis? In your expert opinion, should I have the lip lift before or after my revision rhinoplasty? Thank you very much for your time and guidance. I truly appreciate your expertise.

Gary M. Horndeski, MD · Answer

The fact that you have undergone 5 previous rhinoplasties will not adversely effect doing a lip lift. The circulation is different. A lip lift can be done before the rhinoplasty, at the same time or after the rhinoplasty.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Anna Chacon, MD, FAAD · Answer

Thank you for your detailed message and for sharing your photo. Given your complex surgical history—particularly multiple rhinoplasties including open approaches and use of implants and grafts—it’s understandable that you’d want to proceed with caution.

A lip lift, while a relatively superficial procedure, can pose certain risks in patients who have had extensive nasal surgery. The proximity of the surgical site to the base of the nose, and the shared blood supply between the upper lip and nasal tip area, make vascular integrity a key consideration. After five rhinoplasties, especially one involving cartilage grafting and implant revision, the blood supply to the nasal tip may already be compromised. This increases the theoretical risk of complications such as delayed healing or, in rare cases, nasal tip necrosis.

In general:

It is possible to safely undergo a lip lift after multiple rhinoplasties, but careful evaluation of your nasal vascularity and skin integrity is essential.

I would advise consulting with a facial plastic surgeon who can assess your individual vascular status, possibly through imaging or direct intraoperative observation if done in conjunction with another procedure.

Typically, it is safer to perform the lip lift after a revision rhinoplasty, especially if rib cartilage will be used. This allows for stabilization of the nasal structure and monitoring of post-rhinoplasty healing without introducing new variables.

If nasal tip support and blood flow are intact and your revision rhinoplasty has fully healed (generally after 6–12 months), a lip lift can be considered with proper precautions.

Let me know if you’d like guidance on what to watch for or which providers may be skilled in combining or staging these complex procedures.

I've had five rhinoplasties - Would it be safe for me to undergo a lip lift at some point? (Photos)

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