Should a Lip Lowering Procedure Be Performed Before or After Rhinoplasty/Otoplasty?

I'm a candidate for a lip lowering procedure that would help with my gummy smile. I also need to have rhinoplasty to correct a deviated septum and remove the hump on my nose plus otoplasty to correct my ear. Would the lip lowering procedure affect the other surgeries and should it be done before or after? Thanks

Doctor Answers 11

Lip Lowering Techniques

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Lip lowering techniques are challenging to perform. I would recommend not doing them with a rhinoplasty, but one can do it with an otoplasty. One must be very cognisant of how this procedure is done as results can be unpredictable.

Dallas Plastic Surgeon

Lip and rhinoplasty

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They certainly can all be performed together.  Not only would it save you additional anesthesia and recovery times each result will enhance the other. One of the keys to successful rhinoplasty is facial balance. Lengthening of the lip improves projection on the nose.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Lip Lowering

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If the lip is lowering procedure were confined to the gums, it can be performed simultaneously with the rhinoplasty. However, some discomfort in the teeth can occur after a deviated septum correction. Therefore, it is probably better to do the lip surgery first and then the Septoplasty/rhinoplasty. The Otoplasty can be done with no effect to either surgery.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.5 out of 5 stars 96 reviews

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Lip Lowering Procedure

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Your lip lowering procedure can be done before, during, or after the rhinoplasty/otoplasty surgery. I suggest you do all at the same time so you have one anesthetic and one recovery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Lip lowering procedure

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There is no problem with releasing the upper lip at the same time as the rhinoplasty - you seem to have a lateral component to the gummy smile and may also benefit from Botox to the central lip elevators

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Lip Lengthening Can Be Done With Rhinoplasty And Otoplasty

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The main methods of upper lip lengthening or lowering for a gummy smile are based on a set of static and dynamic manipulations. The upper lip can be vertically lengthened by a V-Y advancement and levator muscle myotomies. In dynamic smile, shortening the maxillary vestibule will also keep the upper lip from elevating so much so that it exposes less gum (really the mucosa of the maxilla) during this motion. There is no medical reason why it could not be combined with rhinoplasty and otoplasty if our surgeon feels comfortable performing the procedure.

Lip Augmentation is the answer

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Your upper lip is very thin and IMHO, you should consider Lip Augmentation with Alloderm or the solid silastic Lip Implant before you cut your lips in an attempt to lower them. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Lip Lowering and Rhinoplasty

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Yes, both procedures can be performed at the same time.  In fact, many surgeons perform both procedures at the same time.  You should discuss your options with your surgeon.


Good Luck.

Rhinoplasty and "gummy smile" surgery.

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It depends on what is being done with the nose. The nose can be done first with release of the nasal base and if this is not enough the lip can be further released after several months.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Should a Lip Lowering Procedure Be Performed Before or After Rhinoplasty/Otoplasty?

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This procedure can be used in conjunction with rhinoplasty. In fact one of the procedure that is used to prevent droopy nasal tip on smiling is to release a muscle in the upper lip that will lenghten the lip as well. However, this may not be enough to lower your lip completely and extensive resection and removal of part of the muscle may be needed to achieve a more long lasting result. 

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.