Upper lip 'pushed in' after rhinoplasty - can this be fixed? (Photos)

Question

My surgeon uses a SEG, and I highly suspect it to be the cause of the change in lip shape. It annoys me, because I cannot make pull my lip down or talk normally for that matter. It gets better when I lift my nose at the base (I don't know why, because a graft would be fixed, but perhaps the tissue is positioned more nicely). Can this be fixed by trimming the graft, and is that an easy fix? I'd rather have a different design anyway (e.g. floating strut, ANSA banner or flexible/slender SEG, or sutures if possible, so my tip can be derotated and lengthened and be mobile), but can it already be trimmed now under local anaesthetic? If it is caused by shortening or rotation of the nose (which I think is less likely, but maybe the caudal septum was cut or so), will derotation/lengthening improve it? Can I push the SEG forward to lengthen the nose and have less pressure on the lip?

Eric M. Joseph, MD · Answer

In general, a septal extension graft is used to elongate somebody's nasal appearance, and this should lead to a lower position of somebody's columella, and a longer nasal appearance. Based on your after photo, I can appreciate that your nasal tip may be a big droopier, and your columella may be a bit retracted, and this doesn't make sense to me. Trimming your septal extension graft would not lead to a result that you are looking for, I suspect. In that regard, please consider meeting with a reputable rhinoplasty specialist who has a large gallery of favorable before and after photos, along with many favorable consumer online reviews. I hope this helps, and I wish you well moving forward. Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty but full pictures of your nose are needed. Maneuvers for your surgery would include tip refinement, nasal tip deprojection, removal of the SEG, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Upper lip 'pushed in' after rhinoplasty - can this be fixed? (Photos)

Answers (2)

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