The incision is custom designed per patient and follows the curvature of the base of the nose. The width of each nasal ala and the width of the columella (central portion of the nose) will affect the incision design. The bullhorn lip lift incision will be near the junction of the nose and upper lip and the central portion is at the base of the columella. Some doctors choose to extend the incision inside of the nose to better hide it, some refer to this as the M-type incision. The problem is that the upper lip then gets pulled into the nose which leads to an artificial appearance and also destroys the nasal sill contour which cannot be replaced. Dr. Linkov believes in making the incision for the bullhorn lip lift procedure at the base of the nasal sill to preserve the natural appearance of the nose.

The answer to this depends in part on which techniques were used during your nose job surgery. Some techniques are more durable than others. Another factor that can impact long-term rhinoplasty results is the aging process, which causes a weakening of the nasal tip and subsequently a droopy tip in some patients. There are methods of more permanently securing the nasal tip during surgery that limits its ability to drop over time (septal extension graft and tongue-in-groove suturing).

Candidates for cheek lift are typically people who have either experienced loss of volume of the cheeks over time or who desire augmentation of the cheeks to enhance their current aesthetic appearance. During the aging process, the skin and fat that comprise the mid face area start to sag, and the underlying facial bones change in such a way that a face that was once shaped like a heart starts to look more like a pear. Additionally, some younger people may simply be dissatisfied with their current appearance and seek augmentation.

Sometimes referred to as an endonasal approach, this technique involves no external, visible incisions. The incisions are made on the inside of the nose and are used to access the necessary areas. This technique was once the most popular approach but has become less popular over time due to limited visibility for the surgeon. This makes it more challenging to learn the techniques and to execute certain rhinoplasty maneuvers. Advocates of this approach believe that one can better judge the outcome during the surgery because the nasal skin remains in place. There is still nasal tip swelling after this type of approach if the tip is manipulated.