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

Question

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

Rod J. Rohrich, MD · Answer

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.

Elliot M. Heller, MD · Answer

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.

Sam Naficy, MD, FACS · Answer

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

David Shafer, MD, FACS · Answer

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.

Toby Mayer, MD · Answer

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.

Michael L. Schwartz, MD · Answer

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.

Barry L. Eppley, MD, DMD · Answer

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.

Mohsen Tavoussi, MD, DO · Answer

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.

Steven Wallach, MD · Answer

If you are having bony facial work to improve the "gummy smile" then a rhinoplasty should probably be done as a delayed procedure.

Richard W. Fleming, MD (retired) · Answer

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.

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

Answers (11)

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