Will A Peri-Pyriform Implant Make My Nose Look Like This?

Q: Dr. Eppley, Let me first give you some background information. About 6 years ago I had several procedures including a rhinoplasty. The dr. that did the rhinoplasty removed something under the base of my nose possibly part of the nasal spine. The result was a change in the angle under my nose. Also my top lip seems to come down lower than it did before. While I know I am not at the point of looking abnormal I would like to look more like myself before the rhinoplasty. When I push up under my nose it looks more like the way it did presurgery. I think this can be achieved with a peri-pyriform implant. I am not sure if silicone or meseline mesh would be the best material. I am attaching photos. the first in each set is with no expression the second ones are of me pushing up under my nose to show the look I want. I look forward to hearing your opinion.

A: Thank you for sending your pictures. What you are demonstrating is not what any type of nasal base/pyriform aperture augmentation will achieve. In fact, it will achieve the opposite effect…pushing out on the nasolabial angle…but it will not push it back up as you have demonstrated nor will it cause the tip to elevate/rotate.

The changes you are demonstrating can only be done by a revisional rhinoplasty in which lower caudal septal resection and suturing the lower ends of the medial footplates of the lower alar cartilages back to the resected caudal septal area is done. That is what needs to be done to drive teh base of the nasolabial angle in a more superior position.

Dr. Barry Eppley

Indianapolis, Indiana