Endonasal Lip Lift - Is it possible to reverse the changes? (Photos)

Question

I had an endonasal lip lift, and I would like to understand to what extent the procedure can be reversed. I had rhinoplasty about 10 years ago, and I was extremely happy with my nose — it felt completely natural and harmonious with my face. Unfortunately, the endonasal lip lift seems to have pulled my columella downward and completely flattened or removed the natural fullness/ridges I used to have at the base of my nostrils (the nasal sill). The way my upper lip now curves and projects also looks very unnatural to me, and I don’t think my facial anatomy was particularly well suited to this type of lip lift. My main goal would be to restore my previous nasal appearance as much as possible: I would like to recreate the natural fullness of my nasal sill and have it sit externally again, restore the position of my columella so that it follows the natural shape and direction of my nose, and allow the base of my nose to rest naturally against the surrounding tissues again rather than appearing pulled downward or under tension, as it does in the photos. I understand that it may not be possible to return exactly to my pre-lip-lift anatomy, but I would like to know how much of these changes could realistically be reversed or reconstructed, and what surgical options could potentially bring me as close as possible to my previous appearance. Here are some before-and-after photos showing the changes I am referring to.

Anna Chacon, MD, FAAD · Answer

I can understand why this would be particularly frustrating, especially since you were very happy with your nose after your rhinoplasty and felt that it had a natural, harmonious appearance for many years. When a procedure around the upper lip changes the relationship between the lip, columella, and base of the nose, even a relatively subtle change can feel very noticeable.

An endonasal lip lift can alter the soft-tissue relationships around the base of the nose. If you are now seeing downward traction on the columella, flattening of the nasal sill, or an upper lip shape that feels unnatural, it is reasonable to consider whether some of those changes can be corrected.

The encouraging part is that revision or reconstruction may be possible, but completely returning to your exact preoperative anatomy cannot always be guaranteed. Once tissues have healed, scar tissue and changes in soft-tissue support can make the anatomy different from what it was before surgery.

The first step would be determining exactly what is creating the appearance you dislike. If there is persistent scar tissue or tethering pulling the nasal base downward, surgical release of the scar and surrounding tissues may help. In selected cases, the nasal sill or columellar area can also be reconstructed or augmented using the patient's own tissue, such as cartilage or a small amount of soft-tissue grafting, depending on what is missing and how much structural support is needed.

If the main issue is the position of the columella or the relationship between the columella and nostril rims, a revision procedure to reposition or support the nasal base may be considered. The goal would be to restore a more natural transition between the nose and upper lip rather than simply pulling the tissues in another direction.

I would be cautious about performing another aggressive lip procedure in an attempt to correct this. When the tissues are already under tension, additional alteration can sometimes make the problem more noticeable. In a situation like yours, preserving as much healthy tissue as possible and carefully addressing the underlying scar and structural changes is particularly important.

It is also worth remembering that photographs can make differences around the nasal base appear more dramatic because of lighting, angle, and facial expression. A proper assessment would need to compare your current anatomy with your older photographs, particularly the pre-lip-lift images, to understand exactly what has changed.

So, while a perfect reversal cannot be promised, meaningful improvement and reconstruction of the nasal sill, columellar position, and surrounding soft-tissue contour may be achievable in the right circumstances. Your previous rhinoplasty being stable for approximately 10 years is also important information when planning any revision, because the goal would be to correct the newer changes while preserving the nasal result you were previously happy with.

Endonasal Lip Lift - Is it possible to reverse the changes? (Photos)

Answers (1)

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