A 20-patient retrospective study in JAMA Facial Plastic Surgery showed an increase in upper lip projection when the nasal tip projection was increased by either a columellar strut or tongue-in-groove maneuver.

This relationship between upper lip and nasal tip projection was first discovered about a year ago by the studyโ€™s second author Steven Dayan, M.D., Chicago Center for Facial Plastic Surgery, who was reviewing some of his post-surgical patients’ photographs.

โ€œAs an innovator in the field, Dr. Dayan is always evaluating facial relationships to better understand the aging process and how to achieve a more harmonious facial rejuvenation,โ€ first author Eric Cerrati,ย M.D., a facial plastic surgery fellow at the University of Illinois at Chicago, tells Cosmetic Surgery Times. โ€œOnce we noticed the relationship and we realized its potential applications, we decided to test the hypothesis by conducting a retrospective study.โ€

The causal relationship was uncovered unintentionally, โ€œbut we were not surprised by it,โ€ Dr. Cerrati says. โ€œThere have been numerous published studies evaluating the relationship between the nose and the upper lip; however, ours is the first to demonstrate that a rhinoplasty maneuver can project the upper lip.โ€

Dr. Cerrati says that most prior studies have placed emphasis on how dynamic upper lip movement is affected by rhinoplasty, such as the amount of teeth and gum that show when a patient smiles.

The current study found that the Z angle demonstrated a statistically significant decrease of 2.7ยฐ.

And while the vermilion height did not change significantly, there was a trend toward an increase in mean height of 0.051.