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Unlike the upper lip, the lower lip has few distinguishing features. While the upper lip has the distinction of a central Cupid’s bow, the lower lip has a straight vermilion-cutaneous line only. It shape is marked by a thicker central region (increased vermilion show) compared to less full sides that extend into the mouth corners. But other than that it has a smooth non-descript vermilion topography.

One aesthetic feature of the lower lip that has gained recent popularity is that known as the lower lip dip or central indentation. The most famous example of this lower lip shape is in Angelina Jolie and is often whom is referred to by women seeking this lip shape change. With the use of injectable fillers its creation is attempted by adding volume to each half of the lower lip excluding the central region. This is done in an effort to create a bilobed lower lip effect. While it can have effectiveness in some patients, it does not have a permanent effect and often fails to create a distinct central lower vertical indentation.

A lower lip dip can be created by a small surgical procedure. Using the natural vertical vermilion lines as an advantage, a vermilion incision is made down the center of the lower lip along the dry vermilion. A wedge of underlying lip tissue is removed but no overlying vermilion is. (an indentation needs more outer lining to be seen not less) When the lower lip heals there will be a central groove or small vermilion cleft.

A central lower lip indentation can have two basic designs. It can have a vertical groove  that extends through the dry and even the wet vermilion. Or it can have more of circular central indentation on the dry vermilion. The surgical technique can be varied to create either lower lip effect.

Dr. Barry Eppley

Indianapolis, Indiana

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