Should I Have Orthodontics Done Before My Augmentation Rhinoplasty?

Q: Dr. Eppley, I have a virtual consult with you last year  but I’m worried that an augmentative rhinoplasty won’t be enough to create proportions within my side profile since my lips are so protruding, so could you confirm if I need my premolars extracted to bring inward the lips before I get the rhinoplasty or will the rhinoplasty be enough? 

A: Good to hear from you again. You have to realize that you have a major nose-jaw size disproportion which can probably never be made ideal. All you can do with the nose is augment it as much as possible with a rib graft as the skin is only going to stretch so much. As for whether it would be enough from your perspective you have to go with what you see on the predictive imaging. (see attached)

Anyone can have their premolars removed and the teeth moved back which will help with the lip protrusion. You would need to consult with an orthodontist to see how this would work in you. With such orthodontic work an augmentative rhinoplasty could be done before, during or after orthodontics. It doesn’t matter since it is known now that you need a maximal augmentative rhinoplasty from which there is no risk that it can end up overdone or too big.

Dr. Barry Eppley

World-Renowned Plastic Surgeon