Can A Lip Lift Be Done If I Have A Retracted Columella?

Q: I read with interest your article about upper lip lifting in the case of a retracted columella.  I’m a 35 year old trangendered male who’s already undergone a feminizing forehead procedure elsewhere.  My upper lip is VERY long and unattractive, but I’ve been told that, because of my nose, to shorted it I’d have to have grafts taken from elsewhere or even have my upper jaw moved, which needless to say I’m not crazy about.  I have a short, upturned nose that I really rather like, but the long upper lip is a big issue and I’m curious if anything can be done without rib grafts or the like.

A: A subnasal lip lift can be done whether you have a retracted columella or not. The ability to do that fairly simple lip lifting procedure is not restricted by a retracted columella or decreased nasolabial angle. It may be aesthetically better to deal with the retracted columella at the same time however. That could be done in a variety of ways, all of which involve the insertion of some supporting graft behind the nasolabial angle. Instead of a rib graft, I would consider a dermal graft which does not need to be harvested from the patient. That could be inserted directly down to the columellar base from the a small opening after the bullhorn lip skin is removed and before final lip closure. But whether you even need that is unclear to me at this point. I would need to see see some lip photos to answer that question.

Dr. Barry Eppley

Indianapolis Indiana