Thank you for your question. It is a relatively common concern these days. In general, it is preferable to do these operations separately as the pull from the upper lip will influence the shape of the nostril sill which in turn influences the appearance of the nostril show. In addition, you will have several areas of instability and healing around the tip and nostrils. This can create some unpredictable effects but not necessarily very serious. The more serious situation is the combination of open tip rhinoplasty and upper lip lift. The incision at the base of the columella and in the middle of the columella can produce a region of the columella skin that loses its blood supply. This can become very difficult problem to fix. Closed rhinoplasty and upper lip lift do not have the same conflict in terms of blood supply to the columella skin.