Upper Lip and Nose Tip Immovable After Rhinoplasty

I underwent closed Rhinoplasty a little over a month ago. Some areas are still numb but it's not the main problem for me. The upper lip feels like it's tucked into inside of the nose, if that makes sense. It's like there are stitches inside or something that holds my depressor muscle, and makes it unable to pull my upper lip down. Even when I try to pull the upper lip down with my hands, it just doesn't let it. It's not just a sensation, but it's an actual feeling that there is something holding my lip inside of the base of columelar area.

I am aware that my surgeon corrected the upper lip angle by cutting the depressor muscle and trimming a little bit of the bone. Current appearance is just normal, and the upper lip isn't numb anymore. But it's still holding the upper lip, and makes the tip of the nose unmovable too. What can this be, and is it normal? If so, why is it happening? How long will it take before I'll be able to freely pull the upper lip down? Thanks!

Doctor Answers 11

Mobility of upper lip after rhinoplasty

There are many different techniques that could have been done at the tip of the nose to make it immovable including cartilage struts and grafts. By resecting the depressor septi muscle, the upper lip movement is not affected. It only prevents the nasal tip from drooping downward when smiling. There should not be anything holding your lip inside the base of your columellar area. All of the numbness and hard, woodiness feeling in the tip usually subsides after three months postoperatively.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Lip and nose not moving after surgery.

After any surgical procedure, your body forms scar tissue for a period of 6 weeks (called the proliferative phase). During this time, your body deposits alot of collagen into the area of injury to help heal it.

Collagen acts to hold the tissues together and can create the sensation of stiffness and immobility that is common with any surgical intervention. In hand /knee surgery, we send patients to physcial/occupational therapists to help things get moving.

I would advise you to stop maniputlating your nose. Nasal surgery can be quite delicated and your frequent pulling with your hand may disrupt the stitches holding wounds together and alter the intended result.

After 6 weeks, wounds start to soften when they enter the remodeling phase.

In regards to the numbness, there are some nerves in the region of the base of the columella that enter the lip and may create some numbness. In most cases, this resolves as it sounds it has done in yours.

Hope this helps!

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Don't give me any lip?


Your complaints of numbness and stiffness after rhinoplasty are not uncommon. There may be many reasons for the lip tightness, ranging from a planned suturing of the lip tissues to the bone at your nasal spine, to merely a perception of tightness from the altered sensation and healing that is taking place.

Discuss this with your surgeon. He/she should be able to shed some light on the subject in your particular case. Good luck!

Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 47 reviews

It is all normal

The stiffness of the tip of the nose and the upper lip as well as the strange sensations take about a year to go away. They always do and the tip skin will be soft and pliable then as it was before.

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

Time is needed

After rhinoplasty, the nose has prolonged swelling and stiffness. It may take two or more years all of this to subside. The numbness usually fades more quickly.

I would advise you NOT to pull on your nose, as it is actively healing. I know that it is annoying to you, but you may do some damage.

Depending on how your nose is progressing, your doctor may give you massage techniques to help soften it faster, and make it more mobile. At present however, it sounds like a normal post-rhinoplasty course.

Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews

Right after rhinoplasty tip/lip are stiff

Your description is very good and gives us a picture of what your surgeon is adjusting with your recent rhinoplasty. If the nasal spine, the bone at the very base of the nose, is prominent the upper lip appears short and the angle between the lip and the nose is very open. As the bone is trimmed the angle is reduced improving the balance between lip and nose.

A suture placed at the spine will reduce the space where the bit of bone was removed and encourage the nose and lip to assume the new shape. Even a permanent suture will relax and lose its thghtness by three to four weeks.

If your nose looks right don't pull on things or test the result. All will soften over time.

Best of luck,

Peter Johnson MD

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Numbness and stiffness after rhinoplasty

In general, almost all noses are numb right after a rhinoplasty. In most cases its the tip that is numb, but this numbness can extend down to the upper lip, and in rare cases some of the teeth. It is also not uncommon that one side of the nose is more numb than the other. There are nerves that are cut and stretched during a rhinoplasty, and it takes a long time for those nerves to start working again. This is true of an open as well as closed rhinoplasty, although it tends to be more extensive in open rhinoplasty. This could also be more extensive if a septoplasty is performed at the same time. This, along with the swelling, gives you a stiff, plastic type feel, and can give you an odd smile. However, the nerves will start working and again, and your nose stiffness will go away with time. This takes in most cases months, but can take years in rare cases. Extremely rarely, the numbness is permanent, although I have never seen such as case. In certain cases where an implant was used, numbness could be caused by compression against the implant, or if it happens years later, then an infected implant can cause numbness as well.
Best Wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

Several possibilities for upper lip stiffness


I agree with the other surgeon's comments. I think there are several possibilities for your upper lip stiffness:

1. Weakness in the upper lip obicularis oris muscle;

2. Scar tissue adhesions after removal of the depressor muscle and nasal spine;

3. A suture to secure the caudal septum to the nasal spine may have caught a bit of the upper lip soft tissue and muscle.

I would advise against trying to pull the upper lip down, but it is ok to exercise this muscle by puckering your lips. I suspect that after 6 to 8 weeks, your problem will resolve.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 45 reviews

Rhinoplasty and stiffness

Stiffness and numbness are common post-operative complaints after Rhinoplasty. They usually get better with time. Just be patient, and hopefully your condition will get better soon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Time will tell!

Dear Lisa,

It sounds like your doctor tried to accentuate the labiocolumellar angle by stitching the crux of the angle up to the cartilage of the nose. This will eventually soften and come down further. Give it more time!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 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.