How Realistic is It to Shorten Philtrum, Decrease Width of Columella, and Expect Good, Natural Results? (photo)

Had a 1st rhinoplasty/septoplasty in 2005 and LeFort I osteotomy in 2012. My upper lip became less visible and pronounced/uneven nasolabial folds. Septum weakened, tip of nose began to "slide" down. In Dec 2010, had septum "re-built" from rib graft and tip raised. Lots of scar tissue formed; 7 months ago, had another revision---all scar tissue removed. Nose is still bulbous, lots of scar tissue, wide base and philtrum. What would you do knowing my hx and seeing photos?? Thanks!

Doctor Answers 4


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You had a very tough case and I think your surgeon did a good job.  I would advise against any major revisions  on your nose but you might benefit from reducing the alar base using small skin wedge excisions.  As far as narrowing your philtrum is concerned, it would involve scars that I do not feel would be worthwhile.  

San Diego Plastic Surgeon
5.0 out of 5 stars 31 reviews

Realistic Expectations for Revision Rhinoplasty

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I suggest you wait another 6 months and then consult with a revision rhinoplasty specialist.I understand your concerns and feel you can improve your appearance.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews


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Yes, I agree with Dr. Mayer.  See your local rhinoplasty specialists and discuss your Nose - Lip goals in detail.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Nasal revision and shortening upper lip.

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You need to see a revision rhinoplasty specialist after at least 9 months for an exam and discussion of the pros and cons of further surgery.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

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