The Modified Bullhorn Approach for the Lip-lift

Spiegel, Jeffrey H.

doi:10.1001/jamafacial.2018.0847

Cited by 20 publications

(16 citation statements)

References 6 publications

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“…The results showed an overall average improvement in the NLA, presenting with 10.9% width reduction and 23.5% lip length shortening assessed 1 year after the surgical procedure (►Figs. [4][5][6][7][8][9][10][11][12][13].…”

Section: Resultsmentioning

confidence: 99%

“…32 It is the "lip position-to-incisal show" ratio that defines beauty, as upper to lower lip ratio is not crucial and lip length is not the key, not until mouth brightness with proper tooth show is restored. 6 It is well reported that both facial soft tissues and bone surgery affect facial aesthetics. Rhinoplasty maneuvers and maxillary movements can improve smile esthetics, columellar-labial angle, and upper lip height, with the latter having a great impact on the appearance of nasal proportion and perception of tip projection considering that its ideal length equals that of the nasal base.…”

Section: Discussionmentioning

confidence: 99%

“…3 Even though the aged upper lip is often neglected by both the facial surgeon and the patient, upper lip-lifting has already been described in the early 1980s as a stand-alone procedure or along with other face-lifting procedures for full face rejuvenation performed both directly at the vermilion border and indirectly through a subnasal or endonasal approach. [4][5][6][7][8] Lips should therefore not be considered as a single anatomical entity, but indeed they must be placed in a strong correlation with the nose, which is the closest and most related anatomical and aesthetic structure of the face.…”

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confidence: 99%

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The Rhino-Lip-Lifting: A Novel Proposal for Midface Profileplasty Performed as a Single Surgical Procedure

Pascali

Marchese²,

Diaspro³

2021

Facial Plast Surg

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As facial aging occurs, aesthetic changes of the nasal tip and the senile upper lip include tip ptosis, increase in skin length, loss of vermillion height and Cupid's bow, and vertical wrinkles.Regardless of the rejuvenation procedure, the lips are not to be considered as a single anatomical entity, instead they should be placed in a strong correlation with the nose. The aim of this study is therefore to demonstrate the effectiveness of the association of primary closed rhinoplasty together with indirect subnasal lip-lifting technique.A total of 45 patients were enrolled in this study and underwent primary closed rhinoplasty with indirect subnasal lip-lifting. The result showed an overall average nasolabial angle width reduction of 10.9% and lip length shortening of 23.5%, as assessed 1 year after the surgical procedure. When comparing before and after photographs and using the Subjective Global Aesthetic Improvement Scale (sGAIS), the overall satisfaction was rated 4.4 on 5, as “much improved.”The authors show that lips should not be considered as a single anatomical entity but that they indeed must be placed in a strong correlation with the nose since a droopy nasal tip is likely to be considered unattractive and is often associated with the appearance of a long nose with covered philtrum and upper lip.Tip rotation to a normal nasolabial angle width could grant a beneficial impact on overall nose aesthetics; however, it may not fully balance the midface profile as it is the “lip position-to-incisal show” ratio that defines beauty, whereas the balance among forehead, nasal tip, upper lip, and chin is what defines the contour of harmonious profiles.This is the first patient series to show that the combination of closed rhinoplasty and indirect lip-lifting is a highly effective, safe, and reliable procedure to address profile rejuvenation.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The Rhino-Lip-Lifting: A Novel Proposal for Midface Profileplasty Performed as a Single Surgical Procedure

Pascali

Marchese²,

Diaspro³

2021

Facial Plast Surg

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“…26 The upper lip may be lifted for greater dental show by decreasing the skin distance between the nose and white roll to 10 to 12 mms. A common lip lift incision utilizes a “bullhorn” or “gull-wing” subnasal excision, which extends around the lateral aspect of the nasal ala, under the columella, and continues to the contralateral ala. 27 Lip lifts are often staged separately from open rhinoplasty procedures.…”

Section: Craniofacial Techniques By Regionmentioning

confidence: 99%

Facial Feminization Surgery Review: Diagnosis, Preoperative Planning, Surgical Techniques, and Outcomes

Choe

Parikh

Barnett

et al. 2021

FACE

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Facial Feminization Surgery (FFS) broadly encompasses a series of surgical procedures offered by craniomaxillofacial surgeons designed to modify facial features and transform both skeletal and soft tissues to create a more feminine appearance. Techniques, initially pioneered by Dr. Douglas Ousterhout, have been modified to include preoperative virtual planning and evolving aesthetic preferences. Computed Tomography (CT) imaging assists with morphologic typing of the brow, supraorbital, chin, and lateral mandible regions. Advancements in instrumentation increase the efficiency and accuracy of FFS procedures. More recently, trends in transgender acceptance have led to improved insurance authorization for FFS procedures. Objective outcome studies have shown success in achieving goals of (1) minimizing mis-gendering in public (appropriately identifying trans-women as female) and (2) reduction in dysphoric feelings (improved patient satisfaction).

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“…Lip lifting can be done along the vermilion border as well as in the bullhorn approach under the nose. 5 The goal is to increase the number of visible upper teeth when the mouth is somewhat open and the lips are at rest. Ideally, four to six upper teeth will be symmetrically visible.…”

Section: Lip Liftingmentioning

confidence: 99%

Lip Lifting: Not Just Fullness—Everything You Need to Know about Lifting and Creating Youthful, Beautiful Lips

Spiegel¹,

Spiegel²

2019

Facial plast Surg

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The Modified Bullhorn Approach for the Lip-lift

Cited by 20 publications

References 6 publications

The Rhino-Lip-Lifting: A Novel Proposal for Midface Profileplasty Performed as a Single Surgical Procedure

The Rhino-Lip-Lifting: A Novel Proposal for Midface Profileplasty Performed as a Single Surgical Procedure

Facial Feminization Surgery Review: Diagnosis, Preoperative Planning, Surgical Techniques, and Outcomes

Lip Lifting: Not Just Fullness—Everything You Need to Know about Lifting and Creating Youthful, Beautiful Lips

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