Will a lip lift distort a rhinoplasty?

Question

Hello, I really want a liplift- Will a lip lift distort a rhinoplasty? My philtrum has become longer as I've aged, The only snag is that I've had 3 rhinoplasties in the past, a very long time ago.,I'm 40. I had my first rhinoplasty when I was 18, but by the time I got to 30 it had changed shape a lot, so I had a revision and this was a disaster and finally the third, which I love! I had a consult and they said it shouldn't do but I would love doctors views? My philtrum is 20mm so could do with a bit off, I would only want to do conservative and not too concerned about a light scar etc, thank you!

Gary M. Horndeski, MD · Answer

Lip lifts usually do not distort a rhinoplasty. I do not recommend the traditional bullhorn lift because it pulls more centrally giving the bunny appearance. I recommend an eccentric lip lift. This does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

There are some plastic surgeons who do not recommend doing nose surgery and lip lift in the same time. It depends how extensive rhinoplasty procedure is as well as whether that is open or closed rhinoplasty. Extensive work around columella, columella cartilage grafts, allar rim grafts, etc. may need to heal and stabilize before new intervention in lip/nose junction is done. Lip lift is procedure that can be done in local anesthesia, with fast recovery and it should not be attempted if it may compromise nose surgery result. Hope this helps. Good luck.

Anna Chacon, MD, FAAD · Answer

This is a very thoughtful and reasonable question, especially given your history and how carefully you’ve approached previous surgeries.

In general, a conservatively performed lip lift does not distort a well-healed rhinoplasty, even in patients who have had multiple nasal surgeries in the past. By 40—and with your last rhinoplasty done a long time ago—the tissues of the nose and upper lip have long since stabilized. At that point, the nose is no longer “changing shape” from surgery itself.

A lip lift works by shortening the philtrum (the space between the nose and upper lip), usually by removing a small strip of skin just beneath the base of the nose. When done conservatively, it enhances lip show and balance without pulling on or reshaping the nose. In fact, in many patients, it can actually improve the harmony between the nose and lips, especially when the philtrum has lengthened with age.

The key factors that matter most in your situation are:

How conservative the lift is (which you’ve already stated is your goal)

Scar placement and tension control

Respecting the nasal base and prior surgical anatomy, particularly important after revision rhinoplasties

With a philtrum length of 20 mm, a modest reduction is very reasonable and commonly performed. Removing just a few millimeters can make a noticeable difference without creating tension that would affect the nose or alter a rhinoplasty result you’re happy with.

Your concern is very valid—especially after going through revisions—but based on what you’ve described, a carefully planned, conservative lip lift should not undo or distort a successful rhinoplasty. The fact that you’re realistic about scarring and focused on subtle improvement is actually a very good sign that your expectations are aligned with what the procedure can safely achieve.

Will a lip lift distort a rhinoplasty?

Answers (3)

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