Dr. Steven Denenberg's facial plastic surgery before and afters: Rhinoplasty, combination noses #7

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In these photos we see another clue, that his nose is over-projecting. In the after photo, draw these two imaginary lines: a mostly-horizontal line drawn along the base of his nose, and a line drawn along the skin from the base of his nose down to his upper lip. Those two lines meet at a sharp angle. In the before picture, however, they don't. The line that traces the skin of his upper lip curves forward to meet the bottom of his nose in the before photo.

If you grab the tip of your nose and pull it forward, making your nose more projecting, your upper lip skin will do the same thing. When the upper lip skin pulls forward like that, we call it "tethering of the upper lip," and it's usually an indication that the nose is a projecting nose.

The rhinoplasty section of the Surgery tutorials contains a chapter that discusses the phenomenon of upper lip tethering (the surgery tutorials contain explicit photographs taken during surgery).

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All views of this rhinoplasty patient:

rhinoplasty 1: Right oblique	rhinoplasty 2: Left profile	rhinoplasty 3: Left oblique	rhinoplasty 4: Right oblique

rhinoplasty 5: Left oblique	rhinoplasty current: Right profile	rhinoplasty 7: Base

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Questioner: My Nose Profile Has These Awkwards Lines. How Can This Particular Problem Be Fixed?
Depending on light and shadow, they are more or less evident, making my nose creepy. Also, I've been wearing glasses since I was 10 - I'm 20 now. Can these marks be a consequence of wearing glasses?
(Questioner submitted photos)

Dr. Denenberg's answer: The lines may adjust when the shape of the nose is changed, if that's a priority for you
Hi. It's never predictable how the skin will drape and fold over the nose. Were you thinking of changing the shape of your nose, too? If that were done, the folds might redrape in a way to make them less conspicuous, though it's not really predictable. See my "Web reference" link for a morph of a proposed change to your nose.

I brought it back closer to your face, raised the tip a small amount, and lowered the hump. Those are typical changes that patients request. You can see how that would change how the skin has to drape on your nose, and maybe for the better.

As far as changing the lines if you don't want to change your nose, I don't really encourage fillers, for example. I would probably just leave them alone.

Link to this question on RealSelf.com


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