Can An Overdone Subnasal Lip Lift Be Fixed?

Q: I am interested in getting a subnasal lip lift as my upper lip is way too long and is getting worse as I age. I have several concerns about the procedure, hwoever, and wonder what could be done if undesired results happen. I had a previous rhinoplasty dne through an open rhinoplasty several years ago that I am quite happy with. Since the subnasal lip lift puts an incision at the base of the columella could that stretch or distort the space between my nose and lips and make it appear freakishly short? I know initially it may look a little short and that it does relax and stretch out somewhat later, but what if it doesn’t. Can any secondary correction be done if things didn’t resolve on their own? Thanks for your opinion.

A:  Your concerns about overcorrection in a subnasal lip lift, also known as the bullhorn lip lift, are very valid and it is something I think about every time I do this procedure. This is because of it is overcorrected, too much lip skin removed, there is no recovery from it. There is no aesthetic method of putting skin back once too much is removed. It is for this reason that it is always better to be more conservative than aggressive with this procedure. My rule of thumb on subnasal lip lifts is too never remove more than 1/3 of the vertical distance of skin as measured from the based on the columella down to the height of the cupid’s bow along the philtral column. Sometimes I may only remove 1/4 of that distance. Yes it is too true that it may relax and be undercorrected in some cases later. But it is always easy to repeat the procedure, it is impossible to reverse it if too much is removed.

Dr. Barry Eppley

Indianapolis Indiana