Cutting Inside of Top Lip for Rhinoplasty - Should I Be Nervous?

im getting my nose done soon on feburary 11th 2013 and theres on thing im nervous about! first, what my doctor is going to do to me is remove my bridge by shaving it and then trim the nose and fix the tip of it because i have a droppy effect going on, but the thing is, is he wants to cute the inside of my upper lip to make room on the top of my lip becuase he thinks its to small, should i be nervous of that or no? and then hes gonna stich it up!

Doctor Answers 14

Cutting inside the of the upper lip in rhinoplaty

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i don't think that you need to be particularly nervous.  this is not a frequent technique but it is a well described technique. 

the upper sulcus incision is an approach to the depresor septi nasi muscle.

if your surgeon states that he is going to do this i would imagine you have a plunging tip with smile, an oblique angle between your lip and columella (lower part of nose), and perhaps a "short" upper lip/gummy smile.  - you mentioned some of this in your question.

if these or even some of these are true, that approach and release of the DNS muscle may very well be indicated.

i agree with the other respondents that if you are nervous about it that you should get more clarification.  but dont the fact that they dont use this technique or have not heard of this technique shake your confidence in your surgeon. it is not experimental and it is not a relic either. 

it may turn out that your surgeon has a very sophisticated and science/anatomic based approach to your particular surgery

Austin Plastic Surgeon
4.9 out of 5 stars 63 reviews

Depressor septi muscle cutting

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the surgeon has deciced to cut partially this muscle, in order to get more tip elevation as a plonging tip has been diagnosed.

in case, this is an excellent technique.

no photos,impossible to make any good evalutation, anyway .but you should not be nervous at this stage .

Alberto Di Giuseppe, MBBS
London Plastic Surgeon

Frenulum, lip release in Rhinoplasty

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It is a relatively common practice in patients that have a short upper lip and a depressed tip to relaese the frenulum.  It is that small web of tissue that you can feel with your tongue between the gum above the front teeth and the lip. In some people this tissue is very short and restrictive. From this incision you can also approach the depressor muscles of the columella, the tissue between the nostrils.

Edward Farrior, MD
Tampa Facial Plastic Surgeon
4.4 out of 5 stars 14 reviews

Upper lip incision as part of a rhinoplasty

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Dear Rita

Many thanks for your question. Access to the muscle that can cause a "dynamic tip" - movement of the nose on smiling, can be done via the nose or the upper lip.

The upper lip approach is a perfectly accepted technique.

By dividing this muscle, it can lengthen the upper lip slightly, and stop the tip moving when you smile.

I hope this helps - good luck!


Cutting inside of top lip for rhinoplasty is not necessary

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There is no reason to perform surgery on the upper lip to effect change in the rhinoplasty.  When patients have a very pendulous tip and the tip droops on animation, especially when smiling, release of the depressor septi ligament is performed at the time of the rhinoplasty.  The incision for the release of this ligament is performed through the nose and not through the upper lip.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Nasal Depressor Septi Release

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     The nasal depressor septi release (to prevent tip plunge during animation) can be performed from an intranasal incision or an intraoral incision.

Upper lip incision for rhinoplasty

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From your description of the procedure, it is difficult to determine why your surgeon would recommend cutting inside your upper lip. Typically this is done inside the nose in order to drop the upper lip some or drop the tip. I would ask your surgeon his reason for this approach and what to expect when he/she does it. Good luck.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Cutting inside of lip for rhinoplasty

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It's a bit unclear why your surgeon recommends the upper lip incision during your rhinoplasty. In my experience everything can normally be done using the nasal incisions, even addressing a drooping tip.

You may want to ask your surgeon for more clarification on the reasoning behind this approach.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Sublabial Approach in Rhinoplasty

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It is not clear why an inside the lip approach is needed for your rhinoplasty. It may be to resect the anterior nasal spine or to release the depressor septi nasal muscles. It is not a common approach as all of that can be done through an open rhinoplasty without going from under the lip. It is not a technique that I would be nervous about nor is it unsafe. It is just a question of necessity and it would be helpful for you to better understand what is being achieved through the lip approach.

Lip Incision

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It is a bit difficult to respond without more information.Some photographs would be helpful along with a bit more as to the specifics of what was recommended.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.