Can a rhinoplasty and lip lift be done in one go?

Question

Can I do a rhinoplasty (alar base reduction, tip, columella, Osteotomy) be done and do a lip lift (shortening the Philtrum) at the same time. I was wondering because of insicions/scarring you would have to cut a similar area twice and I'm not sure if that is a good idea.

Alejandro Nogueira, MD · Answer

Lip lift could be done together with your rhinoplasy, as long as it does not compromise it; better assessment required, nevertheless it is the most likely scenario they are compatible, even with the alar wedge reduction since that maneuver shares incision with the lip lift.

Toby Mayer, MD · Answer

Lip lift and rhinoplasty done together? I routinely do these together and results can be seen on my website and others.  If properly done you will have no problem.

Miguel Mascaro, MD · Answer

Thank you for your question.  I am on the conservative camp on this, and the reason being that I have seen too many combo cases whereupon the lip lift scar does not heal properly, or there is a change in the nostril/nasal tip position from undue tension.  I have heard - though never seen - issues with skin and the columella during open approaches.  Due to this, I always recommend patients do the rhinoplasty first, and then the lip lift.  Particularly if there is alar base narrowing as adequate suspension laterally for the lip lift depends on these structures having a solid base to anchor to.  I tell my patients to wait 6 months - that way most of the shifting and swelling will have subsided from the nose, and you don't need to worry about the lip lift incision as much.  You could probably get away with doing it sooner, but it depends on what your nasal surgery was like, etc.  Again, I lean on the conservative side.  Some people will do it at the same time. Talk to your doc, have them explain the rationale behind their decision making process, and go from there.  I hope some of this helps.

Manish H. Shah, MD, FACS · Answer

Hello,Thanks for your question. Both procedures can be performed at the same time but the risk of wound healing troubles and scar migration run higher. Incisions for the nose need to be blended into the incision for the lip at the nasal base to limit damage to the blood supply of the columella and tip via double incisions. You describe a nasal tip rhinoplasty instead of a full rhinoplasty so the amount of dissection is less. If a closed approach tip rhinoplasty could be performed, then the lip lift incision would be the only incision and you should do fine. Most surgeons will recommend that you perform the procedures separately. Being conservative is usually the best answer in elective surgery. If you smoke, I would recommend that you stop smoking at least 1 month prior any combination procedure. I would also recommend that you consult with a rhinoplasty specialist in a major metropolitan area who has performed complex midface surgery for more information. I hope this helps.Dr. Shah

Barry L. Eppley, MD, DMD · Answer

While the scar locations for an open rhinoplasty and subnasal lip lift are not in the identical location, they are close. (one at the mid-columella and the other at the base of the columella) Thus it is best to separate the procedures both for scar healing reasons as well as their effect potential effects on each other along the nasal base.

Regina Rodman, MD · Answer

This is a great question, thank you for bringing it up. Like many things in surgery, the answer is "it depends."  Not a great answer, right?
I have done limited rhinoplasty and lip lifts at the same time.  An endonasal rhinoplasty and lip lift is likely safe.  However a full open rhinoplasty and lip lift done at the same time increases the risk of wound healing problems, and a stretched (and visible) scar.  When you add an alar base reduction, I think you cross into "don't do it" territory. 
The key to lip lift is a well concealed scar.  With an alar base incision and a rhinoplasty there is too much change happening to the tissues and the likelihood of getting a visible scar is too high.  If it were me, I would not take that risk. 
Further, a lip lift can be done under local anesthesia in the office.  Since you don't need to go back to the OR for the lift, you don't save any money or time doing it under anesthesia at the same time as your rhinoplasty.  You just increase risk, which is not the name of the game in cosmetic surgery

Best of luck
Dr Rodman

William Portuese, MD · Answer

Probably best to do the rhinoplasty  first, then reevaluate the need to  perform the lip lift. Rhinoplasty is a difficult endeavor, so choose your surgeon wisely based on extensive experience

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,In most cases, yes, both rhinoplasty and lip lift procedures can be performed at the same time. Every patient’s case is different; this question would be better accessed during an in person consultation with a facial plastic surgeon. Best,Dr. S

Richard W. Fleming, MD (retired) · Answer

I do the lip lift and rhinoplasty during the same operation when both procedures are necessary. Studies have shown that this is a safe operation.

Can a rhinoplasty and lip lift be done in one go?

Answers (9)

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