What can be done for extreme nostril pull as a result of too much skin removed during lip lift procedure?

Question

Too much skin was removed so the inside of my nose is pulled down and visible and my columella is stretched. My doctor said distortion wasn't possible due to his specific technique. That clearly wasn't the case because I now have a pig nose. Recently, he tried to anchor my nostrils higher but it didn't hold. Now, he is suggesting cinching my nostrils closer together. If that doesn't work he is telling me I need reconstructive surgery. My nostrils look disgusting. Is there any hope?

Miguel Mascaro, MD · Answer

Thank you for your pictures.  This is a difficult situation as you noted that the maneuvers that your surgeon has tried have had little effect.  In general, when this does happen, sometimes it can be secondary to scar tissue build up on to the muscle and can take up to two years to settle down.  However, based on how active your surgeon has been in trying to help you, they probably already tried the "wait and let things settle".  Truth be told, without a preoperative photo, its hard to give you any definitive insight into what cant and can be done.  Your surgeon is trying to help you, and that open communication that you are having with him is fantastic.  It may not be a bad idea to get your preoperative photos from their office as well as a set of post operative photos that way when discussing it with other docs we can get a good idea of where you started, where you ended, and what can be done to improve your situation.  I hope some of this helps.

Farhad Rafizadeh, MD · Answer

I am sorry you feel this way about your post operative appearance, but without seeing how you looked before it is impossible to conclude that your lip lift has caused any problem. The only thing I see that could be corrected in your nostrils is a bit of notching that is not usually the consequence of a lip lift. An alar rim graft could correct that. This is a small cartilage graft that is taken from your septum or your ear and place at the nostril rim to improve the notching. This procedure can be done under local anesthesia in the office.

Lucas Bryant, MD · Answer

I'm sorry you are feeling this way. Without any preoperative photo, it's really hard to comment. Your current nasal contour appears to be within normal limits without having a pre-operative comparison. It sounds like your surgeon is actively trying to help you, so keeping a clear line of communication open is helpful. Warm regards.

Gary Linkov, MD · Answer

Postoperatively, after a lip lift, you can anticipate bruising and swelling that will be noticeable to you and others for about 1 week. After the sutures are removed or dissolve, depending on the type used, there will be redness along the incision line for 4-6 weeks but this can be covered with makeup. Sometimes the upper lip lift is overcorrected with the initial procedure and will slowly assume its final position over weeks to months. 
What type of technique was used? Were incisions made into the nostrils? My guess is that they were. If that is the case, then nostril change is possible. If however, the incision stayed just outside of the nasal sill (not within the nostrils), then my guess is that the deep fixation sutures were not enough to prevent downward pull of the nostrils in the healing process. How far out are you from surgery? You can always seek another opinion from a lip specialist. 
Consult with an experienced lip surgeon for a complete range of options that are appropriate for your situation.
Gary Linkov, MD
Manhattan
Lip Lift Specialist

What can be done for extreme nostril pull as a result of too much skin removed during lip lift procedure?

Answers (4)

Answer: Lip lift postop

Answer: Lip lift postop

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What can be done for extreme nostril pull as a result of too much skin removed during lip lift procedure?

Answers (4)

Answer: Lip lift postop

Answer: Lip lift postop

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Everything you need to know about Lip Lift

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