Horizontal Line Above Lip and Lower Columella Feels Fleshier, Yet Flabbier? (photo)

I had the following procedures 3 years ago acc to post op report. open rhino, submucous resection, spreader grafts o dorsum bilateral, rasp the dorsum, mild tip reduction. My question is I have a horrible horizontal line above my smile and my tip seems to point down. I feel a strange hollowness in upper lip with a thick flesh right below the hanging columella. It looks like I now grimace and ruined a very nice smile. I am very depressed about it, please tell me how this may have happened.

I have seen others who have this crease above smile (grimace) as a result of rhinoplasty. Are there any long term solutions? I saw botox as a possible solution but am hoping for something permanant. What causes this to happen? I also have huge circles under my eyes now, but I have seen every sugeon says this is not from rhinoplasty so I am not going to open that can of worms, as I already know your replies. Thanks for your answers

Doctor Answers 5

Line above lip post-rhinoplasty

It may have something to do with the submucous overresection of the septum. A physical exam by an experienced nasal surgeon will be able to determine the cause. While it's impossible to make an accurate determination of your options over the internet, my assumption is that this is correctable. Please be sure to see a board certified and experienced rhinoplasty/septoplasty surgeon.

Fargo Plastic Surgeon
4.9 out of 5 stars 18 reviews

Horizontal Line Above Lip and Lower Columella Feels Fleshier, Yet Flabbier? (photo)

    If this line was not present before rhinoplasty and is present now, this may be the result of nasal depressor septi release, among other things.  However, this maneuver usually lengthens the distance between the nose and the upper lip.  It is also possible that if the distance is short between upper lip and caudal septum that nasal depressor septi release could be performed to help.  I would have to see the nose in an exam with and without animation to give a better idea.  Kenneth Hughes, MD Los Angeles, CA 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Upper lip issue after rhinoplasty

I can not see the line that youa re talking about, best to be seen in person to be properly evaluated fo this issue.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Horizontal line of the upper lip below columella.

This is not a frequent occurrence in my practice of 35 years. The photos are not adequate to give you a proper answer. You can submit photographs as per my website for instructions.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Horizontal Line Above Lip and Lower Columella Feels Fleshier, Yet Flabbier?

Sorry I can not see the issue you  are describing in the posted photos. But this creasing following open rhinoplasty is a common occurrence. Best to be seen in person by a rhinoplasty surgeon. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

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.