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

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

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

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.

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.

Rita, I would agree with the other surgeons here that suggest you get more clarification on this issue. It is quite unusual to cut the upper lip from the inside during a rhinoplasty procedure. Wishing you the best of luck.

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!

 

An internal upper lip incision is an unusual decision in rhinoplasty.  Generally, the base of the columella and the anterior nasal spine area can be accessed fine from the rhinoplasty approach used to reshape the nose.

My advice:

1. Post some pictures so the Realself doctor community can look at your situation and offer some comments

2. Maybe have a second opinion from another experienced rhinoplasty surgeons before proceeding to rhinoplasty.  Always worth further thought!.

Good luck.

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.

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.

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 .