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

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.

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.

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.

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.

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.

In general a lip lift and rhinoplasty can be done at the same time. However, this depends on the type of alarplasty that is needed and there are some limitations to this. A lip lift would not address the columellar retraction or nostril show. It seems your tip is underprojected and over-rotatated which also gives a perception of a longer lip. I recommend an in-person consultation with a revision rhinoplasty and lip lift expert to determine a realistic improvement. Good luck.

Based on your photos, I see two problems: you have insufficient projection of your nasal tip and your columella is retracted. A lip lift would not correct either of these problems. I suggest an umbrella graft, which should improve bot of your problems.
You have small nostrils, so I would not perform an alarplasty, which would make them even smaller.

Thank you for your question and photos, and best of luck.