I have an Italian nose and it's always been an insecurity. My bottom lip is larger than my top and they looked puckered (Photo)

The one single variable that stands out on your profile picture is that your mandible is small in comparison to your maxilla. This classes at dental overbite occlusion, premature double chin and loss of jawline definition, or an upper lip that has more forward projection than the lower lip and the nose looks large compared to the chin.

Lip fillers will make your lips bigger but they will not have much impact on skeletal balance or the lack there of. Chin augmentation would probably be more effective and fillers can be used for that.

The great majority of people have a lower lip that’s larger than the upper lip so that is normal. when doing fillers providers should treat both the upper and lower lip to maintain the natural volume ratio that each person has to maintain a natural look.

In regards to a surgical approach chin augmentation with an implant or sliding genioplasty combined with a reduction rhinoplasty would probably be the perfect combination.

I suggest having a few in person consultations for the local board-certified plastic surgeons or conceivably oral surgeons to get a more accurate assessment and better understanding of various treatment options.

You may get different opinions from different providers. The approach to facial aesthetics including making assessments can be somewhat subjective.

When people have concerns about their facial appearance especially those who are young the primary problem is almost always based on bone structure. Facial skeletal structure is what makes us recognizable as individual people. Soft tissues tend to be very consistent from one person to another but skeletal shape varies as much as human faces are different.

Attempting to treat skeletal problems by soft tissue manipulations often leads to partial improvements.

Consistent and successful surgical approaches should be aimed at treating the primary problem. In regards to facial aesthetic surgery people often balance what seems like an acceptable procedure and often compromise the rather than diving in full force.

In the end it’s a matter of balancing what you’re trying to achieve and what you’re willing to go through.

The most important decision is probably the choice of provider.

Best,

Mats Hagstrom MD

Hi and welcome to our forum!From your photos, I note that your nose is midline, there is no tip droop, and the nasal bridge rides high. There is a small hump of the bridge. The nasal dome is broad and amorphous.Your upper lip lacks a degree of lateral fullness (some consider it desirable).A rhinoplasty will lower the bridge, eliminate the hump, and define the tip. Hyaluronic acid fillers to the upper lip will temporarily increase lip fullness and projection. If permanency is desired, tissue grafts can be placed into the lip. Increasing lip fullness will not affect nasal appearance.Visit a board certified plastic surgeon for in person evaluation and discussion.Best wishes.