Is MIdface Shortening Possible?

Q: Dr. Eppley, I have come to realize that my primary goal is to address the physical length of the area between my eyes and nose. I am dissatisfied with the elongated appearance of this specific region of my face, as it affects the overall balance and harmony of my facial features.

While exploring potential solutions, I have considered a rhinoplasty to achieve nose shortening. However, I am apprehensive that this may lead to an elongated distance between the bottom of my nose and the top of my lips (pilthrum). This outcome could potentially be corrected with a lip lift procedure, as you previously mentioned.

However, I have concerns about the physical position of my mouth after a lip lift, since the position of my mouth will appear too low, which prevents from the desired face shortening aesthetic I hope to achieve.

To provide you with a clearer understanding of my desired outcome, I will be including a visual representation portraying the practice itself. However, I want to emphasize that these pictures are overdramatized and intended to highlight the desired changes only. They do not represent my exact expectations. Additionally, I would greatly appreciate your expertise in exploring any other possibilities/ procedures that could effectively address the length of the area between my eyes and nose, while ensuring facial harmony.

Thank you for your time and consideration.

A: If I understand what you have described and illustrated you are trying to achieve a middle third of the face shortening…which is essentially impossible. This is a common question/goal of many patients but unlike the forehead (upper face) and the chin/jaw (lower face) can not be achieved because the soft tissue can never reduced no matter what happens to the underlying bone. (e.g., a Lefort impaction reduced tooth/gum show but the outside soft tissue does not change. Thus thus leaves only a shortneing rhinoplasty (tip rotation) and/or a lip lift as the only procedures that can alter the perception of the vertical length of the midface.

Dr. Barry Eppley

World-Renowned Plastic Surgeon