Can you tell me why a surgeon said a lip lift is not recommended for people with an upturned nose? What are my options? (photos)

Question

I planned a lip lift surgery in September. Actual philtrum : 20 mm from nose to cupid bow and 18 mm to upper lip. I would like to remove approx. 8mm (I don't know if it possible because my surgeon tell me he will remove the exact skin to avoid a triangle shape - my scars will be placed inside nostrils. I would like to have 7-8mm removed (I don't know if I can without have an unsightly face). My surgeon didn't talk me about the possible contraindication as I have a upturned nose. He only talk me about endonasal procedure. Could you please give me advices.

Miguel Mascaro, MD · Answer

Thank you for your pictures!  To be honest, your surgeon was probably concerned about the scar.  Truth be told, as long as you have a good history of healing, with meticulous work you shouldn't have any issues.  I certainly wouldn't consider your nose upturned by any means to the point of concern when it comes to a lip lift - you may want to discuss this with your surgeon as well.  Also ensure that they understand your goals true to make sure their particular technique will suit your desired result.  best of luck!

Gary M. Horndeski, MD · Answer

A lip lift can be done for people with an upturned nose.  A lip lift 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.  If your distance is 18 mm I would not recommend removing 8 mm.  That may leave too short of an upper lip and may result in a bunny deformity.  I would recommend a more conservative resection as well as larger resection laterally to pull up the corners.Best Wishes,Gary Horndeski, M.D.

Michael P. Morrissette, DDS, FACS · Answer

Based on your photos and the distance of 20 mm, you are a good candidate for the lift lip surgery. In addition, 7-8 mm sounds about right in terms of reduction. I inform patients that the incision generally heals well but can also be lasered if cosmetically noticeable in the future.

Jonathan Kulbersh, MD · Answer

My guess is that the surgeon is concerned about visible scarring after your procedure. However, an experienced, board-certified plastic surgeon will know how to manage the incision with minimal visible scarring afterward. I recommend getting a second opinion before you move forward with your procedure and work with a surgeon that is confident you can achieve an optimal result from your procedure.

Gary Linkov, MD · Answer

The ideal candidate for the Elelyft, or upper lip lift, is someone with a philtral length of 14mm or longer, no upper dental show, and/or a thin upper lip. The nasal base to mouth width ratio needs to be taken into consideration to avoid leaving the lip corners down. 
Based on your anatomy there is no reason why you cannot have a lip lift. With a philtrum of 20mm, I think your estimate of 7-8mm is perfect actually. Would just need to see your frontal view at rest with mouth open to properly advise. Best of luck.
Gary Linkov, MD

Mehdi Sina, MD · Answer

Hi,It is likely because he/she thinks that the scar may be visible. In reality, when the incision is carefully marked and meticulously closed, the scar heals very well. I would consider you a good candidate. Best,

Piotr Osuch, MD · Answer

Can you please attach your profile photo? It's difficult to say if you're a good candidate for a lip lift based on face on pics of your face only. 
As a rule, significantly upturned nose is a contraindication for a lip lift because LL impacts the nose, and after the surgery your nose can be even more upturned. But: everything depends on individual case. Your measurements are correct from the point of view of a lip lift. A lot will depend also on the following variables: your dental show (with mouth relaxed), position of your nose seen from the profile.

best regards, 
Piotr Osuch, plastic surgeon, MD, PhD

Can you tell me why a surgeon said a lip lift is not recommended for people with an upturned nose? What are my options? (photos)

Answers (7)

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