The nasal tip and the upper lip lift are important and contribute to overall facial harmony and aesthetics. The position of the nasal tip has several component parts. They include the skin, the septum, and the entire nasal cartilage complex. Rotating the tip up requires certain procedures that I will address each and every one of these components. The major and most contributory element will be the nasal septum. Therefore rotating the nasal tip upward will require surgical treatment of the nasal septum at its caudal or the area between the nostrils and furthest from the top of the nose. Also, the depressor septi muscle will contribute to the position of the tip.
I have a special technique to achieve tip rotation that includes several measures. I have found these measures to be very successful. In females the angle between the nose and the lip is called the columellar labial angle. It is most attractive and elegant at approximately 100°, give or take one or two degrees in either direction. For males this angle is best at 90°.
The lip lift is usually desired when the length of the upper lip, that is the distance between the nose and the red part of the lip is too long or if more red of the upper lip is desired to be larger. In this case a thin strip of skin is excised at the edge of the upper lip and the red is advanced and sutured. This creates a scar at the upper lip margin. This is the direct lift.
A more dramatic shortening of the upper lip requires an incision at the base of the nose. This will allow the entire upper lip to be shortened significantly. If done carefully the resultant scar will be relatively inconspicuous. Remember rotating the tip up if accompanied by a muscle resection may lengthen the lip therefore care must be taken if these two procedures are done at the same time – which is possible. Therefore tip rotation upward and lip lift or shortening can be combined into useful fulfilling and satisfying procedures to improve facial appearance and harmony