Possible to Reduce Distance Between Nose and Upper Lip with Revision Rhinoplasty?

If the upper lip appears long because the nose is short and upturned then a revision rhinoplasty with cartilage grafting can help to lengthen the nose.

If the upper lip actually is long then a subnasal lip lift will help, although one has to be careful to not pull the columella down.

I'm sorry to hear that you're unhappy with your surgical result. It sounds like you may have columellar retraction (this can occur especially after resecting the anterior nasal spine), but this is better assessed by seeing your nose.

Revision rhinoplasty surgery can de-rotate and re-project the nose. Cartilage grafting would need to be used to provide support to the nose and to improve the possible columellar retraction.

I would consult with some rhinoplasty specialists to see what improvements are possible.

It is very difficult to de-project and derotate the tip of the nose.  There are multiple techniques available to attempt to de-project the nose but only few millimeters is going to be gained no matter what procedure is performed.  The procedures involved with derotating the tip include extended spreader grafts, trimming back the nasal spine, and some full transfixion to derotate the tip.  Cartilaginous dorsal grafts can also be performed if there is a convexity in the bridge.  

Yes, however it may be difficult to increase the nasal projection which will possibly have the effect of shortening the upper lip. Another option is the upper lip lift, which can nicely shorten the upper lip by as much as 3 to 4 mm.

Your upper lip did not get longer after rhinoplasty it only became more visible due to the upward rotation of your tip. Lip height reduction, i.e. the distance between the pink lip (lipstick bearing part) and the coliumella of the nose can be reduced by either a subnasal or vermillion (pink lip)  advancement lift. Both involve an incision (scar) but in EXPERIENCED hands the risks are samll and will fade with time. Not many surgeons do these procedures so you need to find someone who has done a lot.

The junction between the nose and upper lip can be shortened but that requires a gull wing type incision under the nose which may or may not heal to your liking.

Yes it can be done, but you need to find a skilled nasal surgeon to perform this as grafting along the floor of the nose and septum must be performed to be able to build a stable platform to increase your projection and de-rotate the tip of your nose.

Michel Siegel, MD

Tip rotation and projection can be changed and the nasal base augmented during a revision rhinoplasty. I very rarely recommend actual excision of a portion of the long lip, because unfavorable scars are a possible complication.

Hi.

It depends on your exact anatomy, but the best approach may be to actually shorten the upper lip, rather on relying on changing the anatomy of your nose. That should be done only if you do not like the shape of your nose (independent of the lip).

Without a picture I cannot be as definitive in my answer. If you like the nose, I would suggest no further rhinoplasty work. A sub nasal lip lift might work very well for you. It reduces the distance from the bottom of the nose to the vermilion border of the upper lip