can I go from sub5 to htn?

Commisuroplasty is basically never worth it, the potential scars it could leave are too much of a looksmin. They would harm your appearance much more than any mouth width could boost it. I would never even consider it unless you had a legit deformed-level mouth. I think this dude's mouth will look much better after an alarplasty, his current nose width makes the mouth issue more obvious than it needs to be
that doesnt address the heinously narrow mouth though, which is why fillers / mse might be a good idea
 

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