Why is my upper lip/philtrum area unattractive? (Photos)

Question

There's something that looks off about my mouth area, like my philtrum is too prominent or something. I'm already considering rhinoplasty for my bulbous tip. Do I have alar retraction and/or tension lip too?

Steven M. Denenberg, MD · Answer

Your nose is a bit strong in its forward projection away from your face. When that happens, the nose pulls the upper lip forward so the upper lip can flow onto the bottom of the nose. Your nose is also tall, vertically, so from that aspect as well, the nose tries to interfere with the upper lip. After surgery, it's often the case that the upper lip relaxes and would probably look more natural to you. If you take your nose, or anyone's nose, and look at the profile, and pull the tip out forward away from the face, like Pinocchio's nose, you'll see the upper lip pull forward. You just have a small amount of that going on.
I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. How *much* to elevate the tip, or deproject the nose, or change the width of the tip, or make other changes? We figure that out with morphs, well before surgery.  Morphs could also help you identify better just 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 really 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 the surgeon has that information and judgment best.)

Finally, remember 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 in particular needs -- complicated work on the tip cartilages to elevate and deproject and narrow the tip -- 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.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.From the photos you provided it looks like your subnasal area is very short. This looks even shorter because of your droopy tip. I highly recommend you a rhinoplasty surgery, it will change a lot on your face. Your lips will appear more attractive after a rhinoplasty surgery.
Best regards!

Ronald J. Edelson, MD · Answer

You do not have alar retraction but the term tension lip is appropriate. The cartilage under the columella is too long. It is part of the septum and needs to be shortened as part of overall rhinoplasty. Important step to do in your case but surprisingly many surgeons actually add cartilage there. Yours is a straightforward closed rhinoplasty with no cartilage graft needed

Eric M. Joseph, MD · Answer

I believe a tension nose deformity is the same as a tension lip deformity. It stems from a protruding anterior nasal spine. This is a piece of bone at the bottom of your septum that causes an obtuse angle between the base of your nose and upper lip. Based on your photos, you appear to have a large and wide nasal appearance. If you have severe the satisfaction with the appearance of your nose, please consider Consulting with several reputable rhinoplasty specialists who offer computer Imaging. Hope this helps! Dr Joseph

Robert Ciardullo, MD · Answer

What’s wrong with your lip? do you have a slightly hanging Columella and a mildly tethered upper lip. The rhinoplasty may improve the Columella and the relationship between the Columella and the upper lip, reducing the tethered look.

Why is my upper lip/philtrum area unattractive? (Photos)

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