The most common form of lip augmentation is injectable fillers and typical aesthetic reason for doing so is for bigger or more full lips. Far more lip augmentations are done on the upper lip than the lower lip due to the frequent occurrence of the lower lip being bigger. Such size matches are based on how the lips appear frontally where the full length and size of the upper and lower lips is seen.
A less common indication for lip augmentation appears in the side view where one lip is more protrusive/forward than the other. This can seen where there is one jaw more recessed than the other, in cleft lip and traumatic lip injuries and in some people who just have one lip naturally smaller than the other. Getting the lip protrusions of both more even is the goal.
While injectable synthetic fillers and fat is still one way to add lip volume there is also a surgical method as well. While most surgical lip enhancement procedures change the location of the vermilion-skin edge on the outer portion of the lip, the V-Y mucosal advancement changes its fullness by moving mucosal tissue outward from the inside. This is done using a classic plastic surgery tissue arrangement technique known as a V-Y plasty. The mucosa is initially cut in a large V from the wet-dry line of the lip down to the frenulum. The mucosa is then undermined and released from the deeper tissue from the bottom of the V upward until the mucosa rolls onto the visible external lip. The lower end of the V is then closed vertically and the upper portion closed along the original V lines thus becoming a Y closure.
In essence what the V-Y lip procedure does is relocate some of the internal mucosa and some its underlying thickness onto the lip. Its effect is primarily on the central part of the lip and does not enlarge the whole lip from mouth corner to mouth corner. It can be done equally effectively on the upper or lower lip.
Dr. Barry Eppley
World-Renowned Plastic Surgeon