Rhinoplasty Through the Gums, is It Safe?

I'm planning to do rhinoplasty and alarplasty. my worries is that a doctor may insert tip plasty through the gum, I little thought is it safe? tip plasty if it will not sag or change position? whether the technique is safe for good? what if I want to do braces, whether it will affect the position of the tip plasty? I do not know about how rhinoplasty techniques, what I want is a sense of security for the future.

Doctor Answers 8

Rhinoplasty Through the Gums, is It Safe?

Dear Cheri,

Thank you for your question.  Open rhinoplasty (incision along the columella) creates a near invisible scar that most people cannot find even if they are directly looking at it.  If this miniscule scar concerns you, a 'closed' rhinoplasty avoids this with only incisions inside the nose.  You may not have as accurate a placement of the tiplasty through this technique.  There is no reason to go throught the mouth/gums and this can cause problems when trying to anchor the base of the nose. 

Best Wishes,

Pablo Prichard, MD

Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

No advantage doing Rhinoplasty thru gums.

No advantage doing Rhinoplasty thru gums. Choose a surgeon who does natural noses you like and forget trying to figure out unusual approaches. 

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

Rhinoplasty Through the Gums

Generally, it is unusual to go through the gums to place the tip graft.  The mouth is full of bacteria and the tip graft needs to be placed accurately so that it doesn't move later.  There are some other ways to do a tip plasty without making a visible incision; however, please consult with a board certified specialist who can assist you in achieving the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Rhinoplasty through an intraoral approach

 Rhinoplasty is performed by either closed or open techniques through the nose,not through an intra-oral approach. Closed  rhinoplasty techniques  involve incisions placed on the inside of the nose, which can include a tip-plasty,  osteotomies, placement of spreader grafts etc. Open rhinoplasty involves the incision across the columella. Please see the link below to our  closed rhinoplasty photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty Through the Gums, is It Safe?

There are certain maneuvers that are performed through an incision under the upper lip but this relatively uncommon. Tip modifications are performed either through an external or an endonasal (inside the nostril) approach. I am not aware of any approach to the tip via the area under the upper lip. The exposure would be very poor and ensuring any sort of symmetry would be a real challenge through this approach. This approach can be helpful for removing soft tissue or muscle and also for placing pre-maxillary grafts, but not tip work, in my experience. I hope this information is helpful.

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews


Usually only a couple of procedures can be done through the mouth for a rhinoplasty.  These may include removal of the depressor septi muscle to decrease tip droop with smiling; osteotomy cuts and sometimes alar cinch sutures to narrow the alar base.  I have not heard of a tip plasty through the oral approach.  Discuss further with your surgeon.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 47 reviews

Rhinoplasty through the gums

There are two basic rhinoplasty approaches: the open and closed (endonasal) techniques. In addition, some patients benefit from alar base reduction to narrow the nostrils.

Tip rhinoplasty through the gums sounds unusual. It is certainly a technique I am unfamiliar with. I would recommend to discuss the exact surgical plan with your rhinoplasty surgeon.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Most noses can be treated with closed rhinoplasty.


1)  You need to understand a lot better what is going to be done.  Why don't you get another opinion?

2)  Sometimes implants or grafts are inserted through the gum, but a tip plasty cannot be done this way.  Tip plasty is done through the nostrils.  I really think there is a misunderstanding.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 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.