Are These Rhinoplasty Goals Achievable?
Q: Dr. Eppley, I would like to pose the questions my son has regarding the logistics of the plastic surgery and what is achievable and what it not as his guardian.
In his email he asked the following questions :
1. Is it possible to shorten the vertical length of the nose by 5 mm, while reducing it in size (in how much it protrudes outwards, the width of the nostrils, straighten the bridge and sharpen and lift up the drooping tip)
2. Is it then possible to perform a lip lift to reduce the space between the eyes and mouth
3. While operating on the mouth is it possible to
3a. Perform a corner of mouth tuck to reduce the width of the mouth by 5 mm on each side)
b. Do a lip reduction so as to reduce the thickness of the lips
A: In answer to your questions:
1) It is not a question as to whether in rhinoplasty surgery all of those dimensional movements can be done but whether the degree of change (e.g., sharpen, reduce in size) that the patient desires can realistically be achieved. Not knowing what the patient’s nose looks like now or what their exact nose shape goals are I can not say.
2) A subnasal lip lift reduces the distance between the base of the nose and the upper lip. That may create the appearance that the midface is a bit vertically shorter.
3a) While the mouth corners can be brought in 5mms per side, the tradeoff for doing so is a fine line scar from where the old mouth corner was to where it is now. That can be a dubious tradeoff for many patients.
3b) A lip reduction can be done to decrease the thickness of the lips. As a general rule lip size can be reduced in the 25% to 33% range.
Dr. Barry Eppley