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Even after a facelift many patients are left with mouths that do not look happy or younger. This is because a facelift does not really affect the mouth area (contrary to popular perception) and the presence of  marionette lines. Marionette lines (sometimes called puppet folds) are those folds of skin that run down from the corners of the mouth to the jaw line.  These skin folds are only marginally improved by a facelift. Marionette lines make the corners of the mouth turn down, creating an upside down U-shape to the lower face.This shape to the mouth makes one look unhappy and not as young looking as one may feel inside. In my Indianapolis plastic surgery practice, I am often told by patients that people often ask them what is wrong or why are they mad.

Mouth lifts can very nicely correct this problem. Mouth lifts, or more broadly known as perioral rejuvenation, is a combination of lip procedures that can lift up and rejuvenate the mouth area. This is done by changing the position of the corner of the  mouth to a more horizontal  or level position. This can be combined with  injectable fillers to also make the lips temporarily bigger or with lip (vermilion) advancements to achieve a permanent fuller lip.

It is very common to do mouth lifts at the same time of a facelift to get a central and lateral facial rejuvenation. However, they can also be performed as a stand alone procedure in an office setting under local anesthesia. The mouth lift procedure involves removing a small triangle of skin just above the corner of the mouth, making the area around the mouth smoother, tighter and more happy looking. The scars are hidden along the red part of the lip with a small portion of it going away from the corner of the mouth at an angle. The scars are very hard to see afterwards. A mouth lift not only makes one look a few years younger but also has a natural non-operated look to it. (if not overdone)

When done as part of a facelift, other mouth rejuvenating procedures can be done as well. This could include laser resurfacing for vertical lip wrinkles. While complete elimination of these wrinkles rarely occur, significant reduction can be obtained. Fat injections to the lips, as opposed to temporary synthetic fillers, can  provide some amount of permanent lip enhancement.  The harvest, preparation, and injection of fat into the lips is usually done in an operating room setting.   

Dr. Barry Eppley

Indianapolis, Indiana

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