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Archive for the ‘lip lifts’ Category

Double Duck Lip Lift

Saturday, August 27th, 2016

As the face ages many changes occur around the mouth which are well known. Such structural changes include lengthening of the upper lip, loss of vermilion height and tissue thinning and a decrease of the nasolabial angle in some people. (due to dropping of the nasal tip) The combination of tissue lengthening and volume loss with some resorption of the underlying bony pyriform aperture is the culprit.

Many contemporary treatment strategies exist from injectable fillers, neuromuscular modulators to surgical lip lifts. The subnasal lip lift is often viewed as a last resort treatment approach but for some patients it should clearly be the first. There is no more effective method for shortening the long upper lip than the excision of skin. The subnasal technique in lip lifting is often chosen because of its more hidden scar even though its effects is limited to the central part of the upper lip.

In an effort to manage the change in the nasolabial angle during a lip lift, the technique of moving part of the de-epithelized skin into the base of the columella has been previously described. This creates an opening in the nasolabial angle as well as increases columellar length.

In the 2011 Brazilian Plastic Surgery Journal (volume 26), a paper was published entitled ‘Double Duck Nasolabial Lifting’. In this paper the authors describe a procedure designed to both shorten/lift the upper lip as well as change the nasolabial angle. The technique includes a transverse incision of nasal floor and alar margin skin, separation of the upper lip skin from the underlying orbicularis muscle down to the vermilion-cutaneous junction, the placement of a permanent transcolumellar suture between the nostrils, resection of upper lip skin using a trapezoid resection at the nasal floor and an elliptical pattern at the alar margins and final skin closure.

The authors report satisfactory results in 90% of the patients characterized by shortening of the upper lip, increased vermilion exposure (centrally) and opening of the nasolabial angle. They conclude that the “double duck” lip lift technique was effective with good concealment of the scars.

The term double duck lip lift comes from the pattern of the incisions used in the technique. While the pattern of the incisions is not necessarily novel, what is done with the mobilized skin is. Rather than resecting skin across the base of the columella as in the traditional subnasal lip lift, the skin is spared and moved up into the the base of the columella. (after columellar skin mobilization) This is what also creates the central lip shortening as well as the increase in nasal tip projection.

The double duck lip lift isn’t for every patient that wants/needs a subnasal form of lip lifting. But for the properly selected patient it can be an effective technique.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Subnasal Lip Lift with Lateral Vermilion Advancements

Saturday, January 23rd, 2016

 

Background: Rejuvenation of a long upper lip can only be reliably done by removing skin somewhere between the nose and the upper lip. The most common procedure to do so is known as the subnasal lip lift. It is more popular and commonly done than its cousin the upper lip advancement due to the less risky scar location along the base of the nose.

But the subnasal lip lift is often misunderstood at to its effect on the upper lip. It is important to realize that this is a central lip enhancement procedure. It will have no effect on the size or shape of the upper lip outside of the cupid’s bow region. This is understandable as the horizontal length of the skin excision at the base of the nose is no wider than the width of the nostrils.

This limited subnasal lip lift effect must be appreciated before surgery to prevent a vermilion fullness imbalance developing across the upper lip. While the height of the vermilion at the cupid’s bow region is always higher than that at the sides, thin lateral upper lips may look even thinner when the central upper lip vermilion becomes fuller.

Case Study: This 44 year-old female wanted to shorten her long upper lip, give the cupid’s bow more of a pout and show a little more upper teeth. But in demonstrating the effect of the upper lip lift, it was a revelation to her that the sides of the upper lips did not change. A concurrent strategy of increasing the height of the vermilion directly at the sides of the upper lip with the lip lift was planned.

Subnasal Lip Lift with Lateral Vermilion Advancement markings dr barry eppley indianapolisHer upper lip enhancement procedure was done under infraorbital nerve blocks with direct local anesthesia infiltration into the base of the nose and the sides of the lips. A subnasal lip lift was done that reduced the skin distance of the upper lip from 18mm to 13mm along the length of the philtral columns. This was combined with a 4mm lateral vermilion advancements from the corner of the mouth to almost the cupid’s bow.

Subnasal Lip Lift with Lateral Vermilion Advancements result front view Dr Barry Eppley IndianapolisSubnasal Lip Lift with Lateral Vermilion Advancements result side view Dr Barry Eppley IndianapolisHer immediate result showed a total lip enhancement effect of shortening her long upper lip and increasing the vermilion show at the sides of the lip

A subnasal lip lift can not change the sides of the upper lip no matter how it is designed. A simple but often overlooked strategy for a more complete upper lip effect when doing a subnasal lip lift is the lateral vermilion advancement. This avoids a scar along the vermilion-cutaneous junction across the cupid’s bow area where it can be potentially more noticeable.

Highlights:

  1. A subnasal lip lift shortens the vertical distance between the base of the nose and the central upper lip only.
  2. A subnasal lip lift does not increase the height of the vermilion at the sides of the lip.

3. Lateral vermilion advancements are needed with a super lip lift to create a total lip enhancement effect.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Subnasal Lip Lift and Mouth Widening Surgery

Saturday, December 12th, 2015

 

Background: A full upper lip and a broad smile are several mouth features that are associated with youth and attractiveness. While there are a variety of lip enhancement procedures, the lip lift represents just a minority of the cosmetic lip procedures done. Its largely hidden subnasal scar location and the visible upper lip shortening effect give it a limited but defined role in lip enhancement options.

Less has been described about how to manage a ‘small mouth’. A short horizontal distance between the corners of the mouth is often perceived as the width of the mouth that lies within vertical lines dropped down from the pupils of the eyes. Many have asked about how to widen their mouth but have been discouraged from doing so because of concerns about adverse scarring. But cosmetic mouth widening surgery should not be confused with the corner of mouth reconstruction that is done in cases of congenital or traumatic microstomia.

Case Study: This 22 year female wanted to shorten her long upper lip and get more of a prominent cupid’s bow appearance. (the philtral distance was 18mms in length)  In addition she wanted to have more upper tooth show at the bottom of the upper lip smile line. She also felt that the width of her mouth from corner to corner was too small and wanted it widened.

Subnasal Lip Lift and Mouth Widening Procedure design Dr Barry Eppley IndianapolisSubnasal Lip Lift and Mouth Widening Procedure immediate result front view Dr Barry Eppley IndianapolisUnder local anesthesia in the office, a bullhorn pattern skin excision was marked out under the base of the nose and removed. An excisional skin width of 5.5mms was made along the philtral columns, making it almost one-third of the upper lip length removed. At the same time an arrow-shaped segment of skin was removed from outside the corners of the mouth. (horizontal length of 5mms removed on each side) The mucosa at the corners of the mouth was mobilized and brought out to a new corner of mouth position. This created a 1 cm increase in horizontal mouth length.

Subnasal Lip Lift and Mouth Widening Procedure immediate result side view Dr Barry Eppley IndianapolisA subnasal lip lift creates a shorter upper lip which is often associated with a younger appearing upper mouth area. Short mouth widths can be increased by moving the location of the outer corner of the mouth mucosa. (mouth widening procedure) A subnasal lip lift and lateral commissuroplasties can be done at the same time.

Highlights:

  1. The subnasal lip lift accentuates the central part of the upper lip vermilion (cupid’s bow) by shortening the vertical distance of the skin below the nose.
  2. A short horizontal mouth distance can be increased by a lateral commissuroplasty procedure which opens up the corners of the mouth.

3) A subnasal lip lift and mouth widening surgery can be done together for a more complete perioral change.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Female Subnasal Lip Lift

Tuesday, December 8th, 2015

 

Background: There are a variety of upper lip enhancement procedures from injectable fillers to lifts. By far lip lifts represent just a minority of cosmetic lip procedures done and, as a result, is a frequently misunderstood operation. A subnasal lip lift can be confused with a lower lip advancement because they are both excisional procedures. But a lip lift truly does lift the lip up while a lip advancement pushed up the vermilion from below.

The appeal of a subnasal lip lift is that the scar rests in a relatively concealed area along the base of the nose. When performing the procedure it is important to recognize that the interface between the base of the nose and the lip is not a straight line. It is a multiply curved interface hence the urban name for a subnasal lip lift…the bullhorn lip lift. But despite the appeal of the scar location, a lip lift has its limitations and it is important that patients understand what they are before undergoing to the operation.

By removing skin from under the nose, the vertical distance of the upper lip is effectively shortened. That is its primary effect and by so doing there will be an increase in the fullness of the cupid’s bow vermilion. But beyond the centrally located cupid’s bow the vermilion along the sides of the lip will not change. Draw a vertical line down from the sides of the nostrils and any part of the lip lateral to it will be unaffected by a lip lift. Also, contrary to popular perception, a lip lift will not increase upper tooth show. That area is simply too far away from the point of pull to be affected. To improve tooth show at the time of a subnasal lip lift, a lower horizontal vermilion excision is needed at the same time.

Case Study: This 44 year female felt she had a long upper lip and wanted it shortened. She also wanted the lip lift to look natural and not be overdone. The length of the upper lip along the philtral columns was 18mms.

Cali Lip Lift results front view Dr Barry Eppley IndianapolisCali Lip Lift results oblique view Dr Barry Eppley IndianapolisUnder local anesthesia, a bullhorn pattern of skin excision was marked under the base of the nose and removed. An excisional width of 4.5mms was made along the philtral columns, making it 25% of the total upper lip length. At three months after the procedure the subnasal scar redness is fading nicely and the stability of the lip lift maintained at 14mms of philtral column length.

Cali Lip Lift results side view Dr Barry Eppley IndianapolisA subnasal lip lift has a central upper lip effect that is limited to the skin component area of the prolabium. The skin distance of the upper lip is reduced and the cupid’s bow is more pronounced. But the sides and bottom area of the central upper lip remained unchanged.

Highlights:

  1. A lip lift is a lip shortening procedure that affects the central part of the upper lip only.
  2. A well placed subnasal lip lift scar curves in and around the nostrils and columella and is not a straight line.

3) A subnasal lip lift will usually not increase upper tooth show and will not increase the fullness of the sides of the lip.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Long Terms Results of Subnasal Lip Lift

Tuesday, June 30th, 2015

 

Background: Lip augmentation is one of the most popular non-surgical cosmetic facial procedures and is one of the most common sites for the placement of injectable fillers.  But injectable fillers only add volume and in the vermilion deficient lip may create a very pouty lip or ‘fish’ lips. Without adequate vermilion height the filler merely pushes the lip forward and not up as well.

For the vermilion deficient upper lip, there are several surgical procedures to change the location of the vermilion-cutaneous junction. Such change is instrumental in getting a good and natural lip augmentation effect. These two well known procedures are the lip lift and the vermilion advancement. The subnasal lip lift is, literally, a lifting procedure of the lip by removing a segment of skin from right under the nose. It achieves two important effects, shortening the lip-nose distance and creating more of a central lip pout. In some patients and with enough tissue removed more tooth show may also result. (but the risk of excessive tissue removal and a ‘chipmunk look’ can be created with too much  of a lip lift) It is equally important to appreciate that it is does not create a corner to corner lip change and only augments the portion of the nose that lies between vertical lines drawn from the sides of the nostrils.

There are several criticisms/concerns about the subnasal lip lift. Some feel that if only skin is removed there will be significant relapse.(recurrent lengthening) This has led to lip lift techniques that remove or tighten the orbicularis muscle which can lead to its own set of problems. (lip tightness, smile deformity) There is always the concern about the appearance of the scar right under the nose and whether it will deform the nostrils or the base of the columella.

Case Study: This 26 year-old female wanted a lip lift to shorten her lip to nose junction and provide some some additional central lip pout. She already had reasonably good vermilion fullness and did not need/want any direct vermilion augmentation. Given her greater skin pigment there was good presurgical discussion about the resultant scar.

Subnasal Lip Lift immediate result front view 2Subnasal Lip Lift immediate result side viewUnder local anesthesia, a subnasal lip lift was performed removing 25% of the distance of the philtral column. (4mms) Only skin was removed without any muscle manipulations. Only small resorbable sutures were used on the skin as she lived far out of town.

Subnasal Lip Lift long-term results front view Dr Barry Eppley IndianapolisSubnasal Lip Lift long-term results side view Dr Barry Eppley IndianapolisWhen seen one year later, the subnasal scar was barely detectable and there was no nostril/nose deformity. Comparing her immediate and one year pictures, the subnasal lip lift result has remained stable. (no change in the lip-nose distance or the amount of central lip pout)

The subnasal lip lift can be an effective procedure that has minimal risks if it is not overdone or involves muscle manipulation. It must be meticulously measured and executed to be both symmetric with a good scar outcome.

Highlights:

1) The subnasal lip lift is a surgical procedure for enhancing the central part of the upper lip and shortening the nose-lip distance.

2) The amount of relapse or recurrent skin stretching is 10% or less and is not that noticeable.

3) A skin excision (muscle sparing) subnasal lip lift is both safe and effective and has a very low risk profile.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study: Female Subnasal Lip Lift

Monday, August 18th, 2014

 

Lip Augmentation Dr Barry Eppley IndianpolisBackground: Lip rejuvenation is most commonly done by injectable fillers. By adding internal volume the lip gets bigger and, most of the time, looks more aesthetically appealing. But injectable fillers will not work for all aesthetic lip concerns. It can not reduce the amount of skin in the upper lip nor can it increase the amount of tooth show. Should these features of the upper lip need to be improved, an excisional approach is needed.

Excisional lip procedures involve the removal of skin to create their effects. This can be done either under the nose (lip lift) or from just above the upper lip line. (lip advancement) There are specific indications for either excisional lip procedure and they are often confused. Fundamentally, a lip lift only changes the central portion of the upper lip while a lip advancement changes the entire vermilion appearance of the whole lip form corner to corner. Both shorten the vertical length of skin of the upper lip and may improve tooth show. A lip lift accentuates the current shape of the cupid’s bow while a lip advancement can dramatically change the shape of it. The different location of the resultant lip scars are also obviously different.

Case Study: This 26 year-old Hispanic felt that her upper lip was too long and she did not have enough tooth show. She has very reasonable vermilion shape and fullness but she was not opposed to a more pronounced cupid’s bow appearance. She had tried injectable fillers but this did not give her the upper lip look she was seeking.

Subnasal Lip Lift skin segments removed Dr Barry Eppley IndianapolisAn irregular wavy line excision pattern was marked out under the nose in what is often called a ‘bullhorn’ shape. The maximal width of the excision was marked out along the philtral columns based on a preoperative measurement of 15.5mm length with a 5mm skin excision along these lines) The marked excision pattern tapered into the crease at the sides of the nostrils. Under local anesthesia (infraorbital nerve blocks with direct infiltration), the intervening skin segments were excised in two pieces exposing the orbicularis muscle. The lip segments was lifted and sewn in a two-layer closure with resorbable sutures. Antibiotic ointment was applied as the only dressing.

Subnasal Lip Lift immediate result front viewThe results from a subnasal lip lift are immediate as one would expect from the vertical skin shortening. While the upper lip is moved upward to be closed under the nose. There can be a slight pulling down of the base of the nose in some cases. This has led to some surgeons doing deep sutures, sewing either the muscle or the dermis of the advanced upper lip skin flap to the anterior nasal spine. This well-intentioned suture manuever is ill-advised as it can affect how the upper lip moves or cause other distortions.

Subnasal Lip Lift immediate result side viewAs long as not too much skin is removed from the upper lip (never more than 1/3), this slight pulling down effect is temporary and is not of an aesthetic concern. All subnasal lip lifts will eventually suffer some relapse of up to 20% of the skin removed, that is a far easier problem to correct if desired than any type of lip distortion caused by muscle manipulation or deep suturing manuvers.

Case Highlights:

1) A subnasal lip lift is an effective lip enhancement procedure whose effects are limited to the central portion of the upper lip. (cupid’s bow)

2)  A subnasal lip lift will shorten the upper lip with a minimal effect on increasing upper tooth show.

3) A subnasal lip lift should not remove than one-third of the vertical skin distance between the nose and the lip and should never remove or plicate the orbicularis muscle.

Dr. Barry Eppley

Indianapolis, Indiana

Plastic Surgery’s Did You Know? The Beauty of Upper Lip Length

Sunday, March 17th, 2013

 

A lot of attention has been paid to how to create more attractive and sensuous lips. From injectable fillers to lipsticks and lip plumpers, enhancing the lips has much to do with altering the appearance of the pink portion of the lip. (vermilion) But an often overlooked area of the lip is what lies above it…the amount of skin between the nose and the upper lip. If this distance is too long, which often happens with aging, the lip looks smaller and less perky. While there are some dental strategies to help the lip look fuller (tooth lengthening), this produces at best a minimal improvement. The most aesthetic skin distance along the philtral columns of the upper lip (Upper Lip Length, ULL) is anywhere between 11 to 13mms for most women. (for men it can be a few millimiters longer) If you do not have an aesthetic ULL, it can be made by a procedure known as a subnasal lip which actually removes a strip of skin right underneath the nose. Shortening this distance also lifts up and makes the cupid bow’s area more full.

Case Study: The BullHorn Lip Lift in Men

Tuesday, February 19th, 2013

Background: While lip enhancement has long been desired by women, it is not an exclusive female procedure. While men make up a relatively small minority of patients who undergo cosmetic lip procedures, it is not as rare in men as it once was. I see an increasing number of men who recognize that a thin upper lip is not attractive for them and desire a more appealing size.

While the procedures available for lip enhancement in men are no different than in women, there are several subtle differences. Injectable fillers are the most common form of lip augmentation and are highly successful, but it remains of little appeal to many men. Most men do not find the use of needles on a recurrent basis as very motivating. Men are often more interested in a one-time ‘fix’ to their concerns than the need for a recurring treatment. In addition because men do not wear lipstick, the use of the vermilion advancement procedure (even though it is very effective and affects the lip from one corner to the other) may be approached with extreme caution in them.

This leaves the subnasal or bullhorn lip lift as the only surgical option for lip enhancement in men. Putting the scar along the nasal-lip groove at the base of the nose places it in a relatively inconspicuous location in a natural skin crease. As the thin upper lip is almost always associated with vertical skin excess, some reduction in the upper lip skin length is also a benefit.

Case Study: This 50 year-old male wanted to improve his ‘weak’ upper lip. He felt his lip was very thin and it gave him a more aged appearance. Since he was undergoing numerous other facial procedures, he felt this was an opportune time to address his lip concerns as well.

Prior to surgery, subnasal markings for the lip lift were made with a calipers and a fine marking pen. Initially the vertical philtral columns were marked from the nose to the height of the cupid’s bow and measured. (18mms in length). A wavy incision in the subnasal crease was then made from one nostril to the other across the columella in the midline. At 5mms down from the crease along the philtral lines, the lowest extent of the planned excision was marked. The lower skin lip excision line was then marked paralleling the wavy line in the subnasal crease but in a feathering fashion as it came to join the upper incision at the sides of the nostrils.

At the completion of his other facial procedures under general anesthesia, the subnasal skin segment was excised sparing the underlying orbicularis muscle. The upper lip was then lifted and closed, creating an immediate cupid’s bow enhancement effect.

His postoperative course was typical for a subnasal lip lift procedure with minimal swelling and no bruising for the first week after surgery. Sutures were removed at one week after. By three weeks after surgery (as seen here) he looked non-surgical even though the scar was very slightly red. While somewhat visible in a picture taken with a flash, it was not visible in normal room lights or at a speaking distance. Full scar maturation takes months to completely fade.

Subnasal lip lifts can be done successfully in men without creating an abnormal appearance. The key to a natural looking result is to not remove too much upper lip skin. A safe amount of skin to remove in men is either 1/4 to 1/3 of the vertical philtral length presurgical measurement. It is always better to be conservative (1/4) as men have little tolerance for even a small amount of excessive central lip show even if it will settle down 4 to 6 weeks later. While no one wants to have revisional surgery, it is always better to have to do a second stage for further improvement than to remove too much skin which is an irreversible problem. It canc be striking how much difference 1 or 2mms can make in a lip lift.

Case Highlights:

1) The thin upper lip in the male has limited enhancement options, either injectable fillers or a subnasal lip lift.

2) The subnasal lip lift enhances the prominence of the cupid’s bow and shortens the skin distance between the nose and the lip.

3) A key to a subnasal lip lift, particularly in a man, is to not remove too much skin and avoid the’ chipmunk look’.

Dr. Barry Eppley

Indianapolis, Indiana

Postoperative Instructions for Lip Lifts, Lip Advancements and Corner of Mouth Lifts

Sunday, January 27th, 2013

 

Surgical lip enhancements involve removing select areas of skin to increase the vermilion show of the lips or change the angle of the corner of the mouth. These are precise and measured amounts of skin removal that result in fine line scars either under the nose, along the lip edges or extending out from the corner of the mouth slightly.

The following postoperative instructions for excisional lip enhancement surgery are as follows:

1.  Lip lifts/advancements and corner of the mouth lifts have a minimal amount of postoperative discomfort. Few patients ever require pain medication and a few Tylenol or Alleve are all that most patients need for a few days after surgery.

2.  There are no dressings applied after lip and corner of mouth surgery. Only antibiotic ointment is used to keep the suture lines soft and supple, whose primary intent is to make suture removal eventually easier.

3. Be aware that your lips will get increasingly swollen over the next few days after surgery. This is normal and not a cause for concern. Lip swelling does not start to go down until three days after surgery and will take a week or two to go away completely. The use of ice packs on the lips is very useful the first day after surgery to control swelling and improve comfort. You may use them as long as you like. Corner of the mouth lifts have little to none of this after surgery issues.

4. The lips and corner of the mouth suture lines may get wet without any danger of increasing the risk of infection. So feel free to wash your face and shave (men) as needed.

5. The incision lines at the base of the nose (subnasal lip lift), lip lines (lip advancement) or corner of the mouth lift will have sutures that need to be removed in a week after surgery. (unless you are an out of town patient). Apply antibiotic ointment to them three times a day to keep them slightly moist. If any blood has accumulated on the suture lines during the first day after surgery, clean it off with a little water or hydrogen peroxide on Q-tips. There is no need, however, to use hydrogen peroxide on clean suture lines. Just apply the antibiotic ointment.

6. Your lips will feel a little tight when you open your mouth widely. That will take several weeks to a month to return to normal. You may stretch open your mouth and lips as much as feels comfortable. You may eat whatever you like.  Focus on liquids and soft foods for the first few days after surgery.

7. After sutures are removed and the incision lines healed (several weeks), massaging the lips and stretching them gently will help make them feel softer sooner and regain their normal suppleness again.

8.   You may return to any physical activity and work as soon as you would like based on your comfort level with pain and your facial appearance

9.   You may drive when you feel comfortable and can react normally and are off pain medication.

10. If any lip redness, tenderness, or drainage develops after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Consent for Plastic Surgery: Lip Lifts, Lip Advancements and Corner of Mouth Lifts

Sunday, January 27th, 2013

 

Every plastic surgery procedure has numerous issues that every patient who is undergoing a procedure should know. These explanations are always on a consent form that you should read in detail before surgery. This consent form, while many perceive as strictly a legal protection for the doctor, is actually more intended to improve the understanding of the various lip enhancement procedures. The following is what Dr. Eppley discusses with his patients for these procedures. This list includes many, but not all,of the different outcomes from surgery. It should generate both a better understanding of the procedure and should answer any remaining questions that one would have.

ALTERNATIVES

Enhancements of the lips can be done by a variety of synthetic or fat injectable fillers to increase the size of the pink part of the lip. (vermilion) Whether the results achieved by injection techniques is comparable to that of tissue excision and lifting should be thoroughly understood before surgery.

GOALS

The goal of lift lifts and advancements is to shorten the distance between the base of the noses and the upper lip and increase the amount of vermilion show. A lip lift will increase the central lip pout and vermilion show. A lip advancement will increase vermilion throughout the whole lip from one mouth corner to the other. The goal of a corner of the mouth lift is to lift up the sagging mouth corners and create a more horizontal smile or lip line.

LIMITATIONS

There are limits as to how much the lip can be lifted or advanced and how much the corners of the mouth can be changed. The limits to these changes are based on trying to keep the lips looking natural and not overdone and to not making excessive visible scarring.

EXPECTED OUTCOME

Expected outcomes include the following: temporary bruising and swelling around the lips and the corner of the mouth, temporary lip numbness, permanent scars at the junction of vermilion-skin junction (lip lifts and advancements) and away from the corner of the mouth. (corner of mouth lift) All excisional lip procedures may create some temporary stiffness on movement and mouth opening. Healing of the scars and settling any scar irregularities is a process that takes months (6 to 12) to see the final result in many cases.

RISKS

Significant complications from lip surgery are very rare but could include infection. More likely complications could include aesthetic deformities such as asymmetry and irregularities of the vermilion-skin junction (lip lines) asymmetry of lip (vermilion)sizes or mouth corners, suture reactions along the incision lines, and under vs. overcorrection of the desired lip sizes or corner of the mouth changes. Any of these risks may require revisional surgery for improvement.

ADDITIONAL SURGERY     

Should additional surgery be required to adjust the  shape of the lips or corner of the mouth, this will generate additional costs.


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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