Is There an Operation to Reduce a Protruding Philtrum?

Question

My philtrum is over-defined with each of the two parts creating solid tubular lines from the top of my lips to the skin underneath my nostrils. The way it connects to my nose makes it appear as though it protrudes from the rest of my face. Is there any operation that could make my philtrum look normal? (Picture included. Please help!!)

Rian A. Maercks, MD · Answer

Very commonly patients identify a problem on their face that bothers them when it is really something else catching their eye.  Without seeing the rest of your face it is hard to ascertain, but it appears to me that it is mostly flatness or deflation of your nasal base and upper midface/cheeks that draws attention to your philtral columns. I believe that a great aesthetic enhancement would be to blend and balance your face by using fat or an HA filler such as Juvederm to fill your midface- under your eyes, lateral cheeks, nasal base and lips.  I agree that surgically reducing your philtrum would be a decision you will certainly regret.  I hope this helps!

	 

	All the best,

	 

	Rian A Maercks M.D.

Peter D. Hodgkinson, FRCS(Plast) · Answer

This is an interesting question and one I have never been asked before as a cleft lip surgeon.  Most of the time I am trying to give my patients more philtral definition.  Any surgery here could easily upset the delicate balance of the movements of the lip

Houtan Chaboki, MD · Answer

Hi NoSubject in Killeen,

	Plastic surgery on the nose may or may not affect the upper lip. A protruding upper lip may be due to underlying excess bone or cartilage. Reducing this excess hard tissue may allow the upper lip to settle back a bit. However, the natural folds of the upper lip, the philtral columns, are never reduced. In fact, often times plastic surgeons will plump the phitral columns during lip enhancement with hyaluronic acid (Restylane or Juvederm) or fat injections for facial aging. Only after a comprehensive evaluation can a rhinoplasty surgeon help determine appropriate options for you. Best of luck.

	Dr. Chaboki

William Portuese, MD · Answer

There is no operation to reduce a protruding philtrum or make it smaller. It will probably become less noticeable over time with the aging process.

Darryl J. Blinski, MD · Answer

Thanks for posting a photo showing us your concerns. I agree with the previous expert posters, Drs Aldea and Wallach. In over 30 years of practicing plastic surgery I have NEVER seen a request to reduce the PHILTRUM folds! And I agree leave them alone they look wonderful. But if you are hell bent on doing something, try a small, tiny amount of BOTOX to are to help flatten the muscle roll.

Peter A. Aldea, MD · Answer

Regarding: "My philtrum is over-defined with each of the two parts creating solid tubular lines from the top of my lips to the skin underneath my nostrils. The way it connects to my nose makes it appear as though it protrudes from the rest of my face. Is there any operation that could make my philtrum look normal? (Picture included. Please help!!)"

	The vast majority of people have poorly defined philtrums. As a result, there are several ways to accentuate the philtrum but no operations to smooth it. Since we are dealing with very small volumes, any attempts at liposuction would be risky and result in a much greater deformity than what your currently have. Personally, I LOVE your philtrum and would advise you to leave it alone.

	Dr. Peter Aldea

Steven Wallach, MD · Answer

I do not know of any operation or procedure that can make the philtral columns look less defined without destroying the natural appearance.

Is There an Operation to Reduce a Protruding Philtrum?

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