Is it possible to revise an endonasal lip lift?

Thank you for your thoughtful question. Dissatisfaction with endonasal lip lift results, particularly related to nostril shape or philtrum distortion, is not uncommon, and revision can be challenging but is not necessarily impossible.

1. Is Revision Possible?
Yes, revision of an endonasal lip lift is technically possible, but it is often more complex than a standard external lip lift revision. This is due to the fact that the internal (endonasal) approach alters the nasal sill and columellar base, which can affect nostril symmetry, flare, and philtrum proportions in subtle or pronounced ways.

The key factors influencing revisability include:

The degree of structural change made during the initial procedure

Tissue availability and scarring

Whether the nasal sill or base was over-resected, which can make restoration difficult

2. What Can Be Done to Improve the Appearance?
Options for improving your outcome depend on the specific concerns you’re experiencing, but may include:

Structural revision: This can involve grafting tissue or cartilage (often from the ear or septum) to restore contour or symmetry to the nasal sill or philtrum if too much tissue was removed.

Nasal base/nasal sill correction: If the nostrils have been distorted, a skilled facial plastic surgeon may perform a nasal sill reconstruction to restore the original base width or correct retraction.

Philtrum refinement: Minor adjustments can be made with local flaps or filler to improve contour or symmetry.

External lip lift: In cases where the internal approach failed to achieve the desired shortening or resulted in unnatural tension, an external (bullhorn) lip lift may be considered, despite the trade-off of a fine visible scar.

3. Limitations to Keep in Mind

The endonasal route does limit access, making precise reshaping more technically demanding.

If over-resection or scarring has occurred internally, reconstruction is often restorative rather than purely cosmetic.

Revision surgery often carries a higher risk of asymmetry and requires surgeon expertise in nasal base anatomy and revision procedures.

In Summary:
While endonasal lip lift revisions are possible, they are complex and highly individualized. Correction of nostril and philtrum distortion can often be achieved to some degree, especially with advanced reconstructive techniques. The outcome will depend on the extent of initial modification, tissue condition, and surgical goals. A conservative and strategic approach can often restore balance or improve overall facial harmony.

Unfortunately, you have not provided photographs and that is needed to make an accurate assessment.

Best Wishes,

Gary Horndeski, M.D.

We should be able to help you. The key will be to look at the changes that you don't want and determine what to do to reverse those while still keeping or lifting your lip well. I've done lip lifts for 25 years and we also combine them with nose surgery so this is familiar territory.