Hello, This is a great question that comes up frequently. In many cases it is ok to do them together, however when do them at different times, I prefer to do the rhinoplasty first and the lip lift 6 - 8 weeks after. Each case is unique and I decide mostly based on anatomy and what needs to be done during the surgeries. I chose to do the rhinoplasty before the lip lift in cases where we have to move the bottom portion of the those (the columella) up or down to a significant degree, or when we have to create significant reinforcement for a very weak columella. The reason is that when we measure lip lifts, it is very very precise, to the 1/2 millimeter. These measurements have to be done before injections or any swelling in order to get them just right. If we do the measurements and markings before surgery, then move the columella, it will change the measurements of the upper lip. If we wait to do the measurements immediately after surgery, there will be swelling and also distort the measurements. So in cases like this, it is best to do the rhinoplasty, allow for the nose to heal and majority of the swelling to subside over 6 - 8 weeks, then perform the lip lift with good predictability. Doing the procedures together has the obvious benefit of getting both surgeries done at once. This is something that is often chosen by our patients from out of town, who want to avoid traveling again, or those that don't want to take a second time to recover. It is also done when the base of the nose (the columella), does not have to be moved up or down to a significant degree, and will allow the lip lift to be done with precision. The two procedures are best done with their own separate incisions as this leads to the best aesthetic results. However, because the incisions are so close together, especially when the rhinoplasty involves a nostril (alar) reduction, there is a potential increased risk for skin necrosis (skin death) under the nose, particularly in revision cases. This is somewhat less of a risk with one incision, but that leads to an odd, unnatural appearance under the nose. I have done the procedures together many times with great results and no issues, including SELECT revision cases. I do NOT prefer to do the lip lift first and rhinoplasty later, as the rhinoplasty might change the lip due to the issues described above. Also, a good lip lift includes stabilization for the nasal base and nostrils. It is better to do that after the nose modifications are done. These are the main points of concern when deciding. The most important part is to find a surgeon that does both of the procedures very very well a they are both highly precise and nuanced. Discuss these points with them and see what they recommend based on your examination. Good luck!
