Weird top lip after rhinoplasty. Is this normal?

Question

My top lip hardly moves when I speak , when I laugh it will cove my top teeth, and when I smile it will only show a bit of my top teeth and look very very odd. Even when I am just sitting with a straight face my top lip looks like I'm pulling it down, I am very upset and I hope this isn't permanent , is this normal? Will my top lip raise to it's usual self? Will my normal smile return , how can I fix this :( help!! I am two weeks post op!

Richard W. Westreich, MD · Answer

Hi Rhinoplastyjournal123,I disagree with the other answer provided, in that it is completely normal to have movement disturbance of your upper lip a few weeks after a Rhinoplasty. Typically, when tip or septoplasty work is done, the incision will temporarily disrupt the depressor septi muscle, which is at the base of the lip. If grafting is done, it can be more pronounced. Also, if your tip droops when smiling pre-op, many surgeons will cut the muscle completely. This movement issue is so common, in fact, that I have it noted on my pre-operative consents and I discuss it pre-operatively with every patient. This prevents them from getting concerned about a temporary and predictable issue. It may take a few more weeks for your top lip to start moving, but it is not concerning to have this issue 1-2 weeks after surgery. If it persists, then I also would suggest going back to the surgeon to discuss.All the best

Johanna D'Agostino, MD · Answer

No need to worry, it has only been 2 weeks from your surgery. There is still a lot of swelling present that can affect the movement of your upper lip. You will slowly notice improvement.

Jeremy Hunt, MBBS, FRACS · Answer

Hi,It is not uncommon for this to occur and it should correct itself.Depending on the technique of the rhinoplasty the muscles that attach to the base of the nose and elevate the lip can be bruised, or " go to sleep" after a rhinoplasty.  The result is a lip that moves little and hangs low. The effect is temporary though, much like when your foot goes to sleep, and will get better over time, usually a few weeksIf it is ongoing though you should speak to your surgeon about the way the procedure was performedI hope that helps and puts your fears to restJeremy Hunt  .

Pablo Prichard, MD · Answer

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. 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. A revision rhinoplasty is a much harder surgery with a lot of internal scarring to cut through.  This can also be a reason for prolonged numbness.  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. As the nerves grow back, you may feel some tingling, itchiness and on occasion pain. 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.Best Wishes,Pablo Prichard, MD

Peter Callan, MBBS, FRACS, MBA · Answer

I agree.  This is not uncommon, and can even be associated with numbness in some people.  I would not be concerned at this stage.  Wait a few more weeks and things should return to normal. Let your surgeon know.

Robert E. Zaworski, MD (retired) · Answer

There is no reason why you should have a problem with your top lip 2 weeks after Rhinoplasty, unless certain grafts were used.  Follow up with your Plastic Surgeon to discuss your concerns.  Best wishes!

Weird top lip after rhinoplasty. Is this normal?

Answers (6)

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