Unsure Whether I Need a Lip Lift Operation or a Rhinoplasty to Achieve Balance (photo)

Hi,

I can see why you are displeased with the final results, the alar base is certainly widened and the lip is asymmetric.  I agree with many of my colleagues, however, that you should be very conservative in your approach because you do still have very nice features and all you really need is refinement...nothing drastic.

For the nose, alar reduction via lateral wedge or internal (sill) reduction will likely work best to reverse the cause (which you correctly pointed out is due to your maxillary procedure and the release of the normal nasal attachments).  The lip is best addressed with hyaluronic acid injections every 6 months (conservative) or micro-injection of fat.  If you were a member of my immediate family, I would push more strongly for just the HA injections (like Juvederm).

Remember, though, that although these things may improve your areas of concern, the orthognathic surgeries you have had do change your appearance (not worse or better, just different) and this takes some time to get used to.  You have to go through the psycholigic hard work of accepting your new look, which involves letting go of some of the areas that bother you.  I wish you all the best!

The answer is neither. Your face and nose look fine and normal. You can always find someone to operate. You are pretty as you are!

Maxillary osteotomies very commonly widen the width of the nostrils due to the intraoral vestibular incision and muscle release. The width of your nostrils can be reduced by a simple alar wedge procedure which can be done in an office setting under local anesthesia. I would leave your upper lip alone. Any form of a lip lift, while shortening the vertical length of skin between the nose and lip, will increase your tooth show at rest and further distort your lip shape.