Can I purposely use a lip lift to lengthen my columella? (Photos)

Question

Am I a candidate to get an alarplasty at the same time as a lip lift? I received a rhinoplasty + alarplasty 3 years ago. I have a columella that is still receded/hidden and my nostrils show more than I prefer. I’m considering a lip lift because my lip length is growing more than I prefer. Here are my questions: 1. Can I purposely use a lip lift to both shorten my philtrum distance as well as pull my columella down slightly? 2. Am I indeed not a candidate for alarplasty? If I am, is this something that can be done during a lip lift? 3. Cost?

Farhad Rafizadeh, MD · Answer

Your picture shows a long philtrum, a slightly retracted columella, under-projection of your nasal tip. 
A lip lift, at least the way I perform it, could lower your columellar base so that it shows lower than the alar bases. I would shorten your philtrum and increase your vermillion show as well as your teeth show. I can reduce the alar base at the same time. To increase your tip-projection, you would need a columellar strut graft which would be a revision of your rhinoplasty.

Gary M. Horndeski, MD · Answer

From the side view, the contour from your nose to upper lip is quite straight and there is obvious tension.  Doing a lip lift would add more tension on that and would look unnatural.  It may pull the columella down but it may not.  Also, the distance between your upper lip and nose appears to be in the normal range although you have not stated what it is.  An alternative to consider would be a columella graft to increase the columella fullness on the side.

Best Wishes,

Gary Horndeski, M.D.

Toby Mayer, MD · Answer

Revision rhinoplasty without alarplasty for the under projected tip.  NO lip lift as this will make your philtrum too short and the same goes for alarplasty! Your issue is an under projected tip with a pseudo hump. This is based on my 46 years of FFS and nasal surgery for females and TG patients. Don’t rely on imaging but rather actual results.

Brent Moelleken, MD · Answer

While performing a lip lift could pull down on the columellar tissue, the problem is a lack of volume in that area.  Typically a cartilage graft is necessary.  Remember that that area is very tight, so expectations must be realistic.

Jeffrey H. Spiegel, MD · Answer

Yes, you can get an alarplasty, yes we can do it at the same time as a lip lift, and yes it can be used to adjust the position of your columella.
We do these procedures together routinely and have published evidence of the safety of this combination.

Can I purposely use a lip lift to lengthen my columella? (Photos)

Answers (7)

Answer: Columellar augmentation

Answer: Columellar augmentation

Answer: Yes, yes, and yes

Answer: Yes, yes, and yes

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Can I purposely use a lip lift to lengthen my columella? (Photos)

Answers (7)

Answer: Columellar augmentation

Answer: Columellar augmentation

Answer: Yes, yes, and yes

Answer: Yes, yes, and yes

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Recommended reading

Everything you need to know about Lip Lift

Our mission is to create a world where every investment in modern beauty is Worth It.