Rhinoplasty effects on upper lip?

Question

Hello, lots of patients with rhinoplasty experience as well as doctors mention that rhinoplasty can cause permanent changes in upper lip's length, shape or position. That is the result I am trying to avoid. If I do rhinoplasty with closed method or only deproject the upper part of my nose in order to remove hump(and not touch the base at all) will that risk be eliminated? In general, does closed method reduce that risk or is it the same as in case of open rhinoplasty? Thank you in advance.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can understand from your question we definitely recommend open operation because open operation will be both reliable and the right choice for your surgeon to see every area, and for the lip distance, your surgeon may recommend lip lift in the operation.
It would be better face to face consultation.
Best regards!

Anil R. Shah, MD · Answer

A closed rhinoplasty, especially if focused only on removing a dorsal hump without altering the nasal base, generally poses a lower risk of affecting the upper lip's length, shape, or position compared to an open rhinoplasty. This is because the closed approach avoids incisions on the columella and typically involves less extensive dissection, which can reduce the likelihood of altering the soft tissue and muscle attachments around the upper lip. If you are looking for a large change we almost always recommend the open approach. An open approach may alter the affects of the lip during the healing process but won't make a huge difference in the overall outcome. However, any rhinoplasty procedure carries some risk of changes, so it's important to discuss specific concerns and goals with your surgeon.

Eric M. Joseph, MD · Answer

Our patients may experience temporary heaviness of the central portion of their upper lip, however, by 6 to 12 months after surgery, somebody smile should completely return to normal. The only way to permanently affect somebody smile maybe to remove upper lip musculature during rhinoplasty surgery and we have never performed that technique. I hope this is helpful. Sincerely, Dr. Joseph

Caner Kacmaz, MD · Answer

When it comes to surgery, rhinoplasty can affect the look and projection of the upper lip  permanently. It is something that needs to be discussed with your surgeon prior to surgery

Steven M. Denenberg, MD · Answer

The only difference between an open rhinoplasty and a closed is the tiny incision across the columella. (And in my personal opinion, making that incision allows for sooo much better of a result, because I can see what's going on!) Anyway, the presence or absense of that 7 millimeter cut can't change what's going on in the lip.

Lip changes can happen, but the risk depends on what's being changed about the nose, and by how much. I frankly don't know what surgical techniques predispose to that risk, because I haven't seen it in person.

So, what to do? I'd be worried about having you address just the upper bridge of the nose, in fear of changing the lip, and ending up with a nose you don't like very much because, for example, the tip is still too wide, or droopy, or projecting. You could look at surgeons' before and after photos of patients who had similar tip changes that you are seeking and see whether you see lip problems in the after photos.

So yeah, be very wary about limiting the operation for fear of changing the lip. Perhaps better to do nothing at all: if you lower/narrow the bridge and leave the tip alone, the tip might be too prominent after surgery in a bunch of ways, and would draw more attention. See?

If you *do* decide to have tip changes, how *much* to elevate the tip, or deproject the nose, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. From your description of the issues, the changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

Rhinoplasty effects on upper lip?

Answers (9)