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Lip Lift Surgery



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Getting a lip lift is more invasive than having just a filler injected, or even to have lip implants surgically placed. This type of lip lift is performed via the excision of sub-nasal skin to show greater tooth show and to roll the lip out to create a greater vertical red lip height relative to the upper sub-nasal lip. This is a great procedure for the upper lip that is too long vertically. 

As we age all the bones of the body (including the face) retract and diminish allowing the flesh of the face to hang more. The mouth undergoes many changes as it ages. The upper lip lengthens and sags, the vermilion thins out and takes on a "set" look.  The corners of the lips start to droop, and the structural design of the lip becomes muted as the "lip roll" and the philtrum flatten and the "cupid's bow" loses its curves.

Eventually with age, the lower teeth, rather than the upper teeth, show when the lips are slightly parted.  Vertical wrinkles, the nasolabial folds become deeper, and the marionette lines can actually start to give a person a “down-turn appearance and unhappy” look.  The lower lip changes as well however; not as dramatically as the upper lip.

The lip lift is performed to shorten the long lip of aging, allowing the upper teeth to show again when the lips are slightly parted. It also will show more of the upper lip vermilion, making the thin upper lip appearing more youthful.






Another option to lift the upper lip is not to place the scar at the upper lip but to place it beneath the nose. This is called a sub-nasal lip lift or bullhorn lip lift. In this procedure, the cutout of skin is done right under the nose, so when it is closed, the scar lies in the natural groove at the base of the nose. This does hide the scar well. As the width of the cutout of skin is just the width of the nose, only the central portion of the upper lip (Cupid’s bow area) actually gets lifted. The sides of the upper lip stay the same as they get no effect of the central upward pull from the skin cutout. This is the other difference that distinguishes the sub-nasal lip lift from the more traditional upper lip advancement. 

This procedure shortens the distance between the top lip and the tip of the nose allowing for more upper tooth show when the lips are slightly parted.  The Bullhorn Lip Lift procedure tends to show more of the upper lip vermilion, therefore creating more "poof" in the upper lip.

In this procedure the surgeon outlines a new lip border above the existing one.  The skin between the existing lip border (called the vermilion) and the new border is removed. The lip is elevated to its new position exposing about 1/8” of teeth and permanently increasing the volume of the pink part of the lip. The lip tissue is then stretched and sutured into place, leaving the sutures in place for 5-7 days. The scar that lies in the shadow crease between the nostril sill and the lip is virtually invisible.

Most plastic surgeons use the tissue only method with doing a Bullhorn Lip Lift.  There are however, some surgeons who will operate on the orbivularis oris muscle besides the skin while doing the upper lip lift.  This is known as a muscle lip lift.  There tend to be more complications using this technique so it is not widely accepted or recommended. Severe stiffness and numbness can be experienced lasting for many months and in some cases can be permanent.  It has been reported that muscle and nerve damage has occurred from this suturing technique.

With the bullhorn lip-lift you also have a risk of scarring under the nose.
Bullhorn lip-lifts also can change the shape of your nose.  With most people this scar fades but if you do not scar well or have a history of developing keloids then any of the lip-lift procedures are not for you.  Also asymmetry, numbness and lumpiness might occur as a result of this procedure.




An Italian Lip Lift consists of two separate incisions beneath each nostril. Skin is removed and the right and then the left lip are each separately lifted by closing the wound and reducing the distance between the lip and nose.





Another lip-lift procedure that is done but is not as popular is called the Gullwing lip-lift often referred to as the Vermilion Lift. The incision is made all along the vermilion border at the junction where the pink part of the lip meets the flesh-colored part above your top lip. Then a strip of skin (the flesh-colored part) is removed and the lip sutured to the now higher skin. This also creates a reduced lip to nose ratio. However, scarring along the entire upper lip is a risk.





Another procedure that is usually intended for the lower lip is called the V-Y Plasty lip augmentation. One to three small “V” shaped incisions are made in the mucosa of the lip (the wet part inside the mouth) and then they are sutured in the shape of a Y. The top of the V is left open and heals thereby expanding your lip and creating elevation of the inner lining of the lip where the upper lips and lower lips would meet if you closed your mouth.

This procedure can correct the increased bottom tooth show from a drooping lip that often develops as we age. When doing this procedure, surgeons are very careful to stay away from the musculature underneath the mucosa, so that they do not injure superficial nerves. If these nerves are injured you can develop permanent numbness.  A lot of surgeons have actually stopped using the VY Plasty because of the risks of nerve damage and also the fact the end result is very subtle. 



Corner lip-lifts are also done for people that have a sad look because the outer corners of their lips turn down. The incisions are made on the exact edge of the upper outer lips.  A small triangular area of skin at the corner of the mouth is removed so that the lips turn up slightly in a more youthful manner. The corner of the mouth lift provides an alternative to patients who desire a more permanent solution to the management of deep oral commissure grooves. If the grooves are deep and prominent, surgery may not provide 100 percent correction, but there is usually major improvement.  

A downside to this procedure is that you could end up with a “joker smile”.  Another risk factor with the corner lip lift is having a mouth that constantly feels tight which is probably secondary to scar tissue formation with subsequent contracture.

The procedure is performed in a surgical suite and takes about an hour. It can be performed under local anesthesia or twilight sleep and is often combined with other facial procedures. Initial recovery is about a week and full recovery takes a few months.




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