Can a bullhorn lip lift be executed successfully when the patient has a shortened, over rotated nose? (Photo)

Question

I have a shortened, upturned nose, thanks to 2 rhinoplasties. (Note: I had 2 consultations with revision rhinoplasty specialists who said the tip could not be de-rotated.) Given I have no shelf under which to hide a lip lift scar, can laser treatments really work to make a scar almost invisible? Also, given that I already have a lot of nostril show, what is the risk of nostril distortion? How is the skin anchored? I had a lot of cartilage taken out of the bulbous tip that I once had. Does that matter?

Jeffrey H. Spiegel, MD · Answer

Becoming Stronger,I think that a lip lift is a reasonable option for you. The scar heals well typically as we hide it inside your nose and the crease around your nose.  You shouldn't see any nostril change if that isn't desired.  However, we can also lengthen your nose - derotation is achievable in most case.

Andrea Marando, MD · Answer

Thank you for your question and photos. I can see from your photos the rotation of the tip of your nose but rather than de-rotate your tip, I believe that your nose -  should you ever decide to do anything - could be moderately lengthened (which will de-rotate the tip). However I agree that it is a challenging case and you should see someone who is very confident and experienced. In a bullhorn lip lift there is always a small risk of distortion of the nostrils, even if limited. It also depends on how strong is the support of your tip and the quality of your skin and subcutaneous tissue at the base of your nose. I hope these information will help you.All the best.Andrea Marando

Barry L. Eppley, MD, DMD · Answer

Besides the fact that any nose can be derotated to some degree providing one has the cartilage grafts to do it, a subnasal lip can be performed with the nose in its current state. As long as the lip lift is not overdone (like 4mms - 5mms in your case) nostril distortion will not occur. The subnasal lip scar generally does well in the long-term without the need for laser resurfacing treatments. Given your overall thin lip from corner to corner, you may be better served by a lip (vermilion) advancement however.

Can a bullhorn lip lift be executed successfully when the patient has a shortened, over rotated nose? (Photo)

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