Q: Dr. Eppley, I’m a 33 year-old that doesn’t like how my nose and upper lip looks. At one time I was considering a lip lift but decided against it due to scarring. I am in orthodontic braces as I write this and have been told that I would need to postpone any nose surgery until my braces are off. But I wanted to get your recommendations for my nose as I would like to lessen the upturn of my nose and straighten it. I have no hump to be taken down. It is just the tip that needs to be refined. I have attached some pictures for you to see what my nose looks like.
A: Based on your pictures, the upturn of your nose makes the upper lip look longer than what it really is. You were wise to pass on the lip lift. The tip of your nose is short or underprojected as we call it. This makes your nostrils appear bigger and gives you a lot of columellar show. (strip of skin between the nostrils hangs down too much) The type of rhinoplasty you need is one that would lower your nostril rims and decrease your tense septal angle. (high supratip area) This will require some cartilage grafting from your nasal septum to bring the entire tip downward. This rhinoplasty approach will give your nose and lip a more pleasing appearance. It is not that your upper lip is too long, it is that the tip of your nose is too short.
Dr. Barry Eppley