Tag: upper lip lift

Hot Lips, Cold Sores

Posted on by Randal Haworth

 Stress, weather, chemicals and injury to the lip can all awaken the virus in your body. But needle punctures can be particularly triggering for cold sores.   As one of the Beverly Hills top lip injector of fillers, Plastic Surgeon Dr Randal Haworth does see the occasional cold sore erupt 1-2 days after a treatment. It is for that reason, Dr Haworth recommends antiviral prophylaxis is select cases.

Cold sore herpes Simplex Type I of the lips
Cold sore herpes Simplex Type I which can occur after any lip procedure.

Of course, you can be prone to cold sores, get a lip filler and have no sign of an outbreak. But it’s good practice to be precautious and minimize the risk.

Dr Haworth notes that any cosmetic procedure which causes stress to your skin has the potential to stimulate cold sore recurrence. Cold sores are a prevalent affliction and are generally due to herpes virus (HSV) type one particular (generally oral herpes), with the minority (10%) being due to HSV type 2 (usually genital).

Many main infections of HSV-1 are asymptomatic, while recurrent infections can present as fever blisters at the vermillion border. Although cold sores may well not cause any long-term skin damage, they do possess the potential to cause scarring at the contaminated area.

Roughly two-thirds of a global population under 55 are infected with HSV-1. Primary illness develops in childhood through non-sexual contact usually, for example by sharing utensils or towels, but it is regularly assumed to be solely caused by kissing. If symptoms do present with primary infection, they take place two to 20 days after direct exposure.

Aesthetic procedures such as for example lasers, injectables, microneedling and chemical peeling often require limited or deliberate, manipulated trauma to skin, which includes the potential to trigger cold sore recurrence. Dr Haworth, the world’s foremost lip reshaping expert (including upper lip and corner lip lifts) will even warn his patients that his signature lip enhancements can trigger a herpes simplex outbreak. When a fever blister shows up after an aesthetic treatment, it could be devastating for the individual due to distress, pain and potential skin damage of a cosmetically very sensitive area. You will find a particular likelihood of scarring after ablative types of procedures (lasers, peels).

Cold sore prophylaxis can be recommended in the subsequent circumstances:

-More than three spontaneous occurrences every yea
-Previous eruption at any time, as a result of a procedure
-Lip augmentation and HSV eruption regardless of date or time
-Facial resurfacing procedures; anything that breaches skin carrier, and especially medium or deep peels, facial skin lasabrasion, microneedling and microdermabrasion

Immunocompromised patients

Prophylaxis Dr Haworth recommends includes predosing with Valtrex 500mg daily for 2 days to continue for 3 after the procedure. He’ll substitute 1000 mg daily in particularly susceptible individuals.

Randal Haworth MD, FACS

Has the Upper Lip Lift gone Mainstream?

Posted on by Randal Haworth

Blanketing Instagram may be the pout of the moment: an ample, upturned mouth revealing front pearly whites. It’s a look that has generated a fresh trend in cosmetic surgery: the lip lift. “Social media is driving a whole lot of esthetic selections,” says Andrew Jacono, a Park Avenue cosmetic surgeon, but “the voluptuous lip is not something you may get with injections. Filling lips only makes them appear to be sausages but doesn’t change their condition. Only the upper lip lift can naturally turnthe lip up and out.” The 30-minute office procedure excises tissue from just underneath the nose to shorten the distance between nose and mouth, causing the top lip to relax a bit, exposing more teeth, or “tooth show.” In Gen Z’ers and young millennials, it gives an ideal selfie pout; in older candidates, it can shave up to 7 years from the countenance ($3,000-$10,000).

As upper lips age, they elongate to eventually hide the upper teeth, while lower lips drop to expose the bottom teeth. Beverly Hills plastic surgeon Randal Haworth says lips, like breasts, go over time south. “When Angelina [Jolie] was 19, she had an insouciant mouth and had the Bardot upper tooth exposure ,” he says. “Nowadays her lip is starting to hide her teeth. It is the same with Jane Fonda.” Jacono offers that face-lifts improve the corners of the mouth but don’t address the problem: “Shortening the top lip is probably the most effective esthetic procedures I really do.”

Some surgeons will work with dentists to coordinate how much teeth to show.

“Showing 2 millimeters of tooth while you are at rest is ideal,says Manhattan esthetic dental professional Lana Rozenberg, who claims patients once requested heavier veneers to push away the lip for pout.

Now the Bugs Rabbit look can’t be avoided can be avoided, with surgeons just like NYC’s Oren Tepper working with esthetic dentist Jonathan Levine to open LipSync. “Ten years past, there was an ‘aha’ moment when hands were an era giveaway. Now we realize the mouth is a lot more telling, ” says Tepper.

A before and after of a conservative upper lip liftA before and after of a conservative upper lip lift
A conservative upper lip lift result accompanying the Hollywood reporter article, performed by another plastic surgeon. result accompanying the Hollywood reporter article, performed by another plastic surgeon.

There is one disadvantage to a lip lift; its scar. “You can hide part of the incision inside the nostrils, but there is usually always some visibility at the bottom edge of the nasal area, ” says Beverly Hills cosmetic surgeon Leif Rogers, adding “If not done properly, it can change the look of the nose. “

Dr. Haworth acknowledged this as a problem about 15 years ago, ever since patients began complaining of this subtle nasal change. He realized there were two factors playing a part in this:

  1. Excess tension around the incision line where the upper lip attaches to the nose and …
  2. When the incision is made into the nose in a good faith attempt to hide the scar.

This led him to evolve his methods as a necessity to meet the increasingly discerning tastes of his patients. “Cutting into the nasal still can be a disaster even though it is motivated by goodwill towards the patients. By cutting into the nose, it breaks the circular stability of the nostril itself thus allowing it to “unfurl” and migrate inferiorly.

Another thing I have discovered is that when a lip lift is performed, it mustn’t just resist the downward forces of gravity but it must also resist the hundreds of thousands of mouth movements that occur per day. That’s why I needed to develop the OOS Upper Lip Lift which involves securing the upper lip to the strong lining of the bone around the base of the nose (periosteum). This technique is clearly superior to any skin-only lip lift whether it is modified or not. This results in a superior results in terms of beauty, scarring, lack of nasal distortion and longevity.

http://upperliplift.com

Sophie Monk’s physical transformation

Posted on by omnispear

It would be easy to assume that the changes to Sophie Monk’s face over the years were the result of surgical intervention. According to Beverly Hills plastic surgeon Dr. Randal Haworth, she has not actually gone under the knife. ‘It is human nature for people to jump to conclusions when a celebrity has even the slightest change in appearance. Suspicions and speculations about plastic surgery run wild and I believe Sophie Monk is among the accused!’ the CEO of DrHaworth.com told Daily Mail Australia on Tuesday.

Sophie MonkDr. Haworth stated: ‘Though critics have insisted she had a rhinoplasty or brow lift, I believe she may not have had actual surgery at all. Instead, I sense she took full advantage of some non-surgical cosmetic options. For example, the fact that her forehead is smooth and devoid of normal wrinkles while her outside eyebrows are now higher indicates she was treated with Botox. When applied selectively, Botox not only minimizes wrinkles but can also lift certain facial features such as the eyebrow and the corner of the lips.’ He also turned his attention to Sophie’s plump lips, absence of hollowing under her eyes and prominent cheeks – all signs of non-surgical intervention.

Sophie, who hails from Queensland’s Gold Coast, has admitted to having filler to her top lip in the past, following the botched removal of a cyst. ‘Half of my lip was removed with the cyst, and I was advised to get filler in my top lip to help balance it out,’ she told Who magazine in early 2011.

Original Article

The cosmetic procedures behind Tammy Hembrow’s Instagram-perfect look

Posted on by omnispear

Many social media influencers enlist the help of photo editing apps to sharpen up their picture-perfect public image. Beverly Hills plastic surgeon Dr. Randal Haworth believes that Tammy Hembrow may also rely on cosmetic procedures. According to Dr. Haworth, she may have undergone a nose job, liposuction and dermal fillers to achieve her bombshell look. ‘Miss Hembrow is the quintessential Instagram model for our social media world where fake is the new real,’ Dr. Haworth said.

The celebrity plastic surgeon went on to claim that she strikingly different in recent photos compared to images of her taken several years ago. ‘Based on what I presume to be filtered photos, she has undergone a striking transformation of not only her facial features but also of her facial shape,’ Dr. Haworth claimed. ‘Her jawline is more defined into a “V-line”. I would even venture to say her chin has been shortened and narrowed compared to her teenage years.’ says Dr. Haworth.

Tammy HembrowAccording to Dr. Haworth, Tammy Hembrow’s lips have also almost certainly been enhanced due to their ‘overly plumped’ appearance. He claimed: ‘Like Kylie Jenner, Tammy has been originally inspired by the Angelina Jolie lip variety. Paradoxically, lips oversized for a face can mature the visage beyond its years.’ His claims come after Tammy was stretchered out of Kylie Jenner’s 21st birthday party at celebrity hotspot Delilah in West Hollywood last Thursday night.

Original Article

Beautiful Upper Lip Lifts without scars?

Posted on by Randal Haworth
When we choose to undergo a plastic surgical procedure, we do so to get a beautiful result which is balanced for the face and one that is as permanent as possible and one which doesn’t interfere with function. I don’t think anyone would argue with the above. Lips are a unique anatomical future. They connote youth, beauty and sexuality. However, their job is not only to look beautiful, they have to also function. This is contrast to a nose or an ear which have no moving parts. And as a plastic surgeon helping to advance the field of lip reshaping surgery (LRS), this is where the challenge lays. When a patient asks me to make them a beautiful set of lips, I have to ensure:
  • a. A beautiful upper lip
  • b. A beautiful lower lip
  • c. Both upper and lower lips harmonize with each other
  • d. The harmonizing upper and lower lips harmonize with the surrounding face in terms of shape and scale (volume)
  • e. The upper and lower lips continue to harmonize well into the future (akin to a long-lasting result)
  • f. Scars are as imperceptible as they can be
  • g. The chance of nasal distortion and other complications are kept to a bare minimum
  • h. Lip function is retained (perhaps even improved with the new found confidence!)
  • i. Recovery is minimized whenever possible
  • j. A patient’s expectations are aligned with reality.
(Of course, “j.” should be at the top of the list. If a patient has unrealistic expectations, then no matter how successful a surgery is, if a patient in the end is dissatisfied, the surgery is a failure to them). One of the cornerstones of lip reshaping surgery is the upper lip lift. Most of us appreciate that beauty is mostly conferred through shape and less so by colour and volume. The lips are no exception. An upper lip that is considered beautiful on a primal, instinctual level is one comprised of a short nose-to-lip distance, a beautiful “O” arch, a visible vermilion balanced with the size of the lower and, of course, an appropriate upper tooth exposure. Sexy After performing thousands of upper, corner and lower lip lifts, the secret to unparalleled longevity and a naturally beautiful lip shape is stability. One must understand that, like the hands, the lips move hundreds of thousands of times a day- eating, talking, expressing and other things that shall go unmentioned in this post. Therefore, for an upper lip lift to be successful in terms of beauty and longevity, it should not only resist the downward pull of gravity but also be stabilized against everyday movement (which contributes to re-stretching of the lip, obvious wide scarring and downward pull on the nose). The OOS (Orbicularis Oris Suspension) superficial muscle technique provides this very stabilization by anchoring the superficial layer of Orbicularis Oris just below the dermis to the periosteum (or lining of the bone) below the nose. (The Orbicularis Oris is the circumferential, sphincter muscle that surrounds the oral aperture). By stabilizing the lip in two directions bilaterally I am able to customize the curl and expression of the upper lip to make it not only youthful but sensual as well. The two direction approach is analogous to the way a marionette can come to life by the hands and strings which control it. The skin-only lip lift is a far simpler operation to perform and solely involves removing skin and sewing the skin edge of the lip to that of the bottom of the nose. The only thing holding the skin-only lip lift in position are the dissolvable stitches in the dermis which are no match against constant daily mouth movement and gravity’s pull. As a result, there is a far greater likelihood of the nostrils being pulled downwards, obvious scarring, significantly decreased longevity and suboptimal aesthetics.
After a "modified "upper lip lift
After a “modified “upper lip lift by another Beverly Hills Plastic surgeon, which is basically a skin-only lip lift marketed as something other than it really is. Note severe right nostril pulldown with bizarre pleat along with an “A frame” deformity and an exacerbation of her downward slanting can’t of her upper lips.
I can personally attest to the dramatically decreased longevity, unremarkable results, worse scarring and nasal distortion from the thousand or so skin-only lip lifts I performed in the 90s. Though the skin-only  recovery is easier, the current version of the OOS upper lip lift may allow the patient to appreciate results as early as 10 days. Not only does the OOS technique shorten the distance between the nose and lip but it also allows upper tooth show( that goes without saying really), subtle added rollout of the upper lip’s pink vermilion, welcomed narrowing of the aperture of the mouth (that gets wider with age) and even noticeable reduction in the nasolabial folds. Contrary to some misperceptions, no muscle is removed and no cases of permanent numbness or any paralysis ever encountered.
After an OOS upper lip lift by Dr Haworth. Note minimal scar and no nostril descent
Upper lip lift enhancement
After an OOS upper lip lift by Dr Haworth. Note minimal scar and no nostril descent
More and more people are realizing that the upper lip lift( and other LRS techniques) may play as important a role as a facelift and eyelid surgery in facial rejuvenation. Choosing proper techniques, performing them well and understanding how all elements of the lip work together can be the ultimate magic trick to transform a face from “Meh to Mwah”! Dr Haworth July 2018

2016 State-of-the-art lip shaping-Dr. HAWORTH on the “Doctors’ show

Posted on by Randal Haworth
Very few surgeons in the world understand aesthetics to the point where they can be a  true hyperaesthetic facial plastic surgeon specialist. A hyperesthetic specialist is similar to the conductor of an orchestra-he or she needs to know all the instruments better than the individual players in order to “orchestrate” them to create melodious harmony without dissonance. One of the keys to create visual harmony in the face is mastering lip rejuvenation surgery-it’s not just about adding volume (which is essentially what most practitioners and patients equate with lip enhancement), it’s about mastering the shape of both the upper and lower lip. Patients travel  from all corners of the globe to top Beverly Hills plastic surgeon and lip augmentation specialist, Dr Haworth to undergo hyperesthetic change, which may include any number of surgical art performances including a high-profile facelift, endoscopic brow lift, blepharoplasty, rhinoplasty or his lip reshaping signature surgery! https://youtu.be/cI3nEq5R3x8

The trials, trade-offs and tribulations of upper lip lifts and other plastic surgery.

Posted on by omnispear
All plastic surgery has trade-offs.

By trade-offs, I am not referring to complications or risks.

By trade-offs I am referring to subtle and sometimes significant alterations in your appearance that will be incurred by undergoing a certain plastic surgical procedure. It is the doctor’s responsibility to inform the patient of these trade-offs (including risks of complications) while it is the patient’s responsibility to make an informed decision to proceed if he or she feels that the benefits of the surgery will outweigh the risks and trade-offs.

Examples of such trade-offs are the scars in and around the ear that result from a facelift. Even though they may be near invisible, they are scars nonetheless. The majority of patients feel that benefits of the facelift outweighed any of the associated trade-offs. Similarly, patients who undergo an abdominoplasty (tummy tuck), mastopexy (breast lift) or brachioplasty (arm lift) should be fully aware that they will develop scars from those procedures. Though the majority will heal well with very acceptable scars, most of the time the scars will be visible to some degree.

Patients who undergo a rhinoplasty must understand that their nose will be numb, stiff and hard for up to 3 months or more while swelling can persist for 1 to 2 years. Numbness from a facelift or a browlift can last many months as well. Despite understanding these trade-offs, the vast majority of patients have no problem undergoing these procedures once they have decided to do so.

Over the years, I have found it curious that a small minority of patients undergoing lip reshaping surgery in the form of upper lip lifts and V-Y plasties had unrealistic expectations in terms of their healing and results. They were surprised even angry that they experienced numbness, stiffness and associated scarring. Sometimes a very subtle change in the nostril position occurred after the surgery. These trade-offs may arise even though the result of the upper lip lift is successful from the aesthetic standpoint-in other words, the net benefit in the sensual-youthful-beauty quotient for the face has been increased. However, a few may consider the lip lift a failure if they have experienced even a slight degree in any of these trade-offs.

Though these trade-offs can mostly be successfully reversed, a patient should not elect to undergo such a procedure if he or she will not accept that these can be normal aspects of the procedure. If one thinks about it, an upper lip lift will have its trade-offs in the same way other procedures would have their own yet it perhaps gets more attention than other anatomical features of the face because the lips are expected to not only look beautiful but also function as well.

And function they do, more than any other part of the face. Indeed, lips are used to express, emote, eat, kiss and speak-essentially they move millions of times a day! Because of these strong repetitive muscle forces around the nasal and oral region the plastic surgeon must create a strong upper lip lift that will resist these forces in order to achieve a result that is long-lasting, with minimal scarring and nasal distortion.

In fact, lip shaping procedures are the most challenging of all facial plastic surgeries, even rhinoplasties. Though the success of facelifts are measured in centimeters, brow lifts in increments of 2 to 4 mm and rhinoplasties in millimeters, lip reshaping surgery is measured in quarter-to-an-eighth of a millimeter! With those scales, one can almost consider this close to microsurgery.

In 2014, it would be a miracle to undergo an upper lip lift with an unequivocal guarantee of no scarring, nasal distortion, prolonged minor sensory changes and stiffness. If you are contemplating undergoing an upper lip lift but will not tolerate any of these tradeoffs, I suggest you avoid the procedure altogether and wait for that miracle to happen.

Lip Lift status for 2014 and beyond

Posted on by omnispear

Lip lifts for 2014

Patients often asked me what are the differences between a skin-only lip lift and my muscle hemming technique. To put it simply, longevity, scarring and nasal distortion.

Skin Only Lip Lift

Until the late 90’s, the only lip lift I knew how to do was the skin only type. I would perform this by excising a certain amount of skin below the nasal base and sewing the lower edge of the excision to the upper edge which happens to be the skin of the nose.  The only thing now supporting this entire weight of the upper lip (which happens to move millions of times a day, eating, kissing, expressing and speaking) is the freshly closed incision at the skin level.  One can imagine that this provides little support for all the action occurring around the upper mouth area.  Consequently, the longevity of the lip lift itself is lessened, the nostrils are more likely to be pulled downwards while the resulting scar is more likely to stretch and thicken.

The results of a skin-only lip lift. Notice the widened scars, significant nostril distortion and recurrent long upper lip.
The results of a skin-only lip lift. Notice the widened scars, significant nostril distortion and recurrent long upper lip.

Muscle Hemming Lip Lift

After many years of observing the long-term results of skin-only lip lifts, I developed the muscle hemming technique.  By employing moderate principles of plastic surgery in which nip and tucks (such as a facelift) are improved by lifting and tightening the layers below the skin including muscle I have noted a significant benefit to my lip lifts in terms of scarring, longevity and less nasal distortion.  However, the recovery period was notably increased.  The muscle hemming technique involves placing slowly dissolvable sutures into the muscle layer below the skin and intern suturing that to the periosteum (lining) of the bone deep to the nose itself.  The lip lift is thus a solid one without relying on skin closure to achieve its  superior long-term results while lessening the chance of undesirable scarring and pulling around the nostrils.

Skin Flap Lip Lift

Which brings me to today.  For the last 3 years I have been employing a skin-flap technique which provides all the benefits of the muscle hemming technique but with half the recovery.  Suturing of the muscle is minimized in this technique but none of the longevity and superior scarring is sacrificed. The period of significant distortion and swelling has been halved from 2 weeks to less than 1.  Additionally, the results are “softer” in appearance with minimal to no distortion of the nostril area.

Patient with subliminal long upper lip with minimal upper toothshow
Patient with subliminal long upper lip with minimal upper tooth show
After skin -flap lip lift by Dr. Haworth of Beverly Hills. Notice significant improvement tooth show, natural shortening of the upper lip with minimal nasal distortion. Being a lip lift expert, he developed surgery during to further his evolutionary journey into perfecting the ideal upper lip lift. This new technique also produces softer results those from the skin-only at muscle-hemming techniques.
After skin -flap lip lift by Dr. Haworth of Beverly Hills. Notice significant increase in tooth show and natural shortening of the upper lip with minimal nasal distortion. Being a lip lift expert, he developed this surgery to further his evolutionary journey into perfecting the ideal upper lip lift. This new technique also produces softer results those from the skin-only and muscle-hemming techniques.

Performing the modern lip lift with minimal-to-no-scarring and achieving a permanent beautiful result is challenging .  It requires attention to minute detail and appreciation of how the oral region plays a central role in facial harmony.  The vast majority of patients are thrilled with the subtle yet powerful results of this operation, but it has taken over 2 decades of  unwavering dedication and imagination to get this far.

Rhinoplasty – “Samurai Nostrils”?

Posted on by omnispear
As one of the leading rhinoplasty specialists in the United States, Dr. Randal Haworth continues to challenge himself to be the best he can be. By constantly questioning his results and asking himself how he can do things better, he feels he is subjecting himself to the highest quality assurance and delivering the best possible outcomes in plastic surgery .

Performing rhinoplasties are one of my favorite specialty since the nose place such a central role in the total harmony of the face. Consider it like one of the leading instruments in the orchestra. Though most plastic surgeons and patients alike obsess on nasal humps, wide bones as well as drooping, boxy, pinched and ill-defined tips and, of course, the width of the nostrils, little attention is paid to the actual shape of the nostrils. In other words, a surgeon should not only assess whether the nostrils are wide at their base, but also whether they are arched, pointy, thick or sigmoid in shape.

One of the most common and unflattering nostril shape is that of the “samurai nostril”. Look at the following two photographs and you will see what I mean.
Seven samurai
Another example of these flared nostrils that may look appropriate as a menacing sign but not a flattering one for beautiful woman
Flared nostrils of the nose before a rhinoplasty
A samurai mask manifesting the flared, aggressive shaped nostrils that are unappealing in a woman


There are a few ways to correct this but probably the most reliable is to harvest a “composite” graft from the hidden portion of one’s ear. This detailed surgery involves insinuating this graft between an incision made on the inside of the nose, corresponding to the actual width of the retracted portion of the nostril. This graft is then sutured into place with the skin side facing the actual inside of the nostril to maintain the continuity of it’s lining. One can lower the nostril about 3 to 4 mm with this technique. Of course, some resorption of the graft occurs so it is best to over-correct this.

Other techniques involve strategic V-Y plasties, which are essentially internal tissue rearrangements of the inner aspect of the nostril in order to lower its rim, cartilage grafts in the actual substance of the nostril to help correct pinched tips while lowering the rim and, finally, filler. These latter techniques, though successful to some degree, are not as effective as an ear “composite” graft.

Note the following two cases in which “composite” grafts were taken from the ear and placed within the nostril to lower them. Of note, simultaneous upper lip lifts to further enhance a feminine appearance were performed.

Preoperative transgender patient with retracted nostrils
Transgender patient was retracted nostrils, long upper lip and droopy corners of the lip


Transgender patient after composite grafts to lower the nostril rims and an upper lip lift with DAO release
Dr. HAWORTH performed a modified rhinoplasty by lowering the nasal arched “samurai” rims (nostrils) as well as an upper lip lift and DAO release to lift up the droopy corners of the mouth


Patient with a long upper lip and retracted "Samurai"nostrils after a previous rhinoplasty
Patient with a long upper lip and retracted “Samurai”nostrils after a previous rhinoplasty by  another surgeon


Dr. Haworth performed an upper lip lit along with nostril rim lowering and fat transfer to the lips
Dr. Haworth performed an upper lip lift along with nostril rim lowering via a composite graft from the ear. Fat transfer was also performed into the upper and lower lips. Notice the more feminine harmony


The Tricky Rhinoplasty and Upper Lip Lift Combination Surgery

Posted on by omnispear
While many surgeons feel uncomfortable with performing an upper lip lift, let alone one simultaneously with a rhinoplasty, it can be safely done. The concern revolves around the fear of losing vital blood supply to the columella (the fleshy straight partition that exists between the nostrils), because if the blood flow is compromised to this area then necrosis or loss of the columellar skin can result. This, in turn, can lead to a possible unsightly scar. If the nose job is performed through an endonasal or closed approach ( whereby all incisions are strictly confined to within the nose itself) there should be little concern for this. However, caution must be exerted when the rhinoplasty is performed with an open technique- one that involves making a scar across the columella in order to gain better access and therefore better visualization and control of the operation. In a normal open technique the incision is placed about halfway up on the columella. Since an upper lip lift necessitates making an incision at the base of the columella (where it joins with the upper lip), the incision needed for the open rhinoplasty can also be the same one- so the incision will be used for two different purposes.

Scar placement for rhinoplasty alone and in combination with an upper lip lift



The situation becomes more complicated, however, when a persisting scar stemming from a previous open nose job is present. In this situation, the plastic surgeon must carefully plan his incisions so as not to compromise the blood supply. More often than not it is safer to keep the upper lip lift incision separate from the rhinoplasty’s in these revision cases. The planning becomes even more critical when the nostrils need to be narrowed during the nasal aesthetic surgery ( Weir excisions). Not only does the upper lip lift need to be blended well onto the columella, but it also needs to be conformed to a freshly narrowed nasal base, with minimal undesired tension across the final scar ( which can increase the chance of it being noticeable). Intricate surgery along with an intimate knowledge of the regional anatomy and the biophysics of an upper lip lift are key ingredients to a beautiful outcome in this combination surgery. Following are two examples of before and afters of this combo surgery.

To view more upper lift results go to:http://www.drhaworth.com/procedures/upper-lower-lip-lifts/

Patient 1.Preop: 52 year old female



After Rhinoplasty with Weir excisions, Upper lip and corner Lip Lifts along with a lower V-Y plasty

Note the improved visual interplay between the nose and upper lip along with youthful tooth show and narrower oral span.



Patient 2.Preop: 35 year old. Note lack of upper tooth show and nasal tip disharmony

Postop after Rhinoplasty, upper lip lift, lower V-Y platy and lip fat transfer