Should I consider a lift along with rhinoplasty?

Question

Hello, I am getting a rhinoplasty and having my columella shortened. I am worried this will make my upper lip even longer. My philtrum is currently around 14mm. My surgeon says my thin skin will not heal well from lip lift scar. Should I pursue the lip lift elsewhere ? Is my philtrum out of balance ?

Steven M. Denenberg, MD · Answer

I see the bump on the bridge, and how the tip seems somewhat strong. But what do you mean by shortening your columella? Your columella, what I can see of it, looks so average-y-normal to me. And a lip lift?! Please, no. Look at that profile, the last posted photo. You have a short columella, not a long one, and I agree that you'd probably hate the scar.Here's something else to make sure you look into. It seems that your bridge is strong up at the top of the nose -- in front of your eyes, or just below your eyebrows. When the nose is strong there, if a prominent bump is lowered, it's important to reduce the strength of the bridge up there at the top, or your profile would resemble the profile of a Roman statue, where the profile of the forehead slides right down onto the nose, without that little dip we like to see in front of the eyes. Search for Roman statue profile to see what I mean. Your surgeon must pay attention to that, too.
How *much* to lower a bump, or lower that part at the top of the nose? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should always be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and only the surgeon has that information and judgment. Another aside: I also recommend that you not show morphs made by one surgeon to a different surgeon. If a surgeon makes his *own* morphs, you get to see whether he understands the important issues of your nose, and how your nose should be changed. But if you show the surgeon someone else's morphs, and he says "Of course I can make your nose look like that," then you don't really know if he fully understands, or even recognizes, the important changes shown in those morphs. And you don't know if he can make those changes during surgery.)
Remember also that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

Gary Linkov, MD · Answer

I would recommend you get the rhinoplasty first, and then consider the lip lift only if needed. At this time, you do not seem to be a great lip lift candidate based on photos.

Nelson Lee Novick, MD · Answer

Over the past twenty twenty years that I have been performing them, rhinofillers or nonsurgical rhinoplasties, i.e. the use of fillers to treat dorsal nasal spine and bridge bumps and humps, have become incredibly popular. Nowadays, fillers are also used, in what has been described as the "Italian Technique," to rotate the nasal tip upward. From the profile view provided, it would appear that you are very likely a candidate for a filler nose job to straighten the spine of the nose, as well as for upwardly rotating the tip of your nose. In experienced hands, both procedures together should not take more than five minutes to perform and the results typically engender an immediate "Wow!" reaction. It might be wise to discuss this option with your doctor before embarking on relatively expensive and aggressive nasal surgery. Wishing you the best of luck. Stay safe.

Gary M. Horndeski, MD · Answer

The distance from the nose and upper lip is 14 mm is certainly an acceptable range.  If you undergo a lip lift, not much skin removal would be required.  You may be better off doing the rhinoplasty and maybe satisfied.  If you are not satisfied then you can undergo a lip lift, if necessary.Best Wishes,Gary Horndeski, M.D.

Jeffrey H. Spiegel, MD · Answer

We published a key paper a few years ago describing the safety of lip lift with rhinoplasty.  Thin skin will heal very well from these procedures - typically better than thick skin.  It may be a good idea to do the two procedures together, though they can be done one after the other as well.  Watch our videos to learn more.

Should I consider a lift along with rhinoplasty?

Answers (6)

Answer: Minimal resection lip lift

Answer: Minimal resection lip lift

Answer: Rhinoplasty and lip lift

Answer: Rhinoplasty and lip lift

Recommended reading

Everything you need to know about Lip Lift

Our mission is to create a world where every investment in modern beauty is Worth It.

Should I consider a lift along with rhinoplasty?

Answers (6)

Answer: Minimal resection lip lift

Answer: Minimal resection lip lift

Answer: Rhinoplasty and lip lift

Answer: Rhinoplasty and lip lift

Browse related questions

Recommended reading

Everything you need to know about Lip Lift

Our mission is to create a world where every investment in modern beauty is Worth It.