Can Some Of The Effects Of My Rhinoplasty Be Reversed?

Q: Hi Dr. Eppley, I need help with my nose and lips. Four years ago I had a rhinoplasty. While no work was done on my lip it changed after surgery. My upper lip seems longer than before.  My upper lip was long to begin with but now it covers my upper teeth and rests heavily on my lower lip when at rest.  My nasolabial angle changed so that it is more of a 90 degree than tethered as it was before.  I am a female 32 years old and was wondering if these problems can be fixed.

A: It is unusual for one’s upper lip to change after rhinoplasty but it is theoretically possible. If the base of the caudal septum, where there are muscular attachments at the anterior nasal spine, is resected to change the nasolabial angle, it is possible that there may be some release of the upper lip as well. If one had a longer upper lip to start with, then the risk of lip lengthening is greater.

Regardless of how it may have happened, a longer upper lip can be shortened by a procedure known as a subnasal lip lift. That can be very effective at reversing your lip lengthening that has occurred and can even make it shorter than were you were prior to your rhinoplasty. As a general rule, an upper lip lift can remove up to one-third of the skin length between the nasal base and the height of the cupid’s bow along the philtrum.

Changing of the nasolabial angle can also be done. While it is far more common to open up the nasolabial angle during rhinoplasty with caudal septal resection, the reverse can also be done.  This would require a septal cartilage graft attached to the caudal septum which is so placed that it pushes back down on the nasal tip cartilages.

Dr. Barry Eppley

Indianapolis, Indiana