V-Y Lower Lip Lengthening Case Example

V-Y Lip Lengthening (V-Y Lip Advancement / V-Y Plasty) is a surgical technique used in cosmetic and reconstructive lip surgery to lengthen and/or add volume to the lips by advancing internal lip tissue rather than adding foreign material like fillers or implants.

What It Is

V-Y lip lengthening (also called V-Y advancement, V-Y mucosal advancement, or V-Y lip lift) is a procedure that:

• Uses a V-shaped incision made on the inside (mucosa) of the lip (upper, lower, or both).
• The underlying mucosa is released and advanced outward toward the vermilion (the pink part of the lip).
• The incision is then closed in a Y configuration, effectively moving tissue forward.

Unlike traditional lip lifts that shorten the distance between the nose and lip, V-Y primarily increases lip volume and visible “pink” vermilion show without external scarring because all incisions are inside the mouth.

How It Affects Lip Length & Appearance

The V-Y advancement:

• Increases projection and fullness of the lip by advancing natural tissue outward.
• Enhances the visible vermilion area, making lips look fuller and more youthful.
• Can also increase vertical height of the lips — effectively lengthening them — though isolated effects on lip length (as opposed to projection and show) aren’t fully quantified in all cases.
• Is best used for a central vermilion kip deficiency where a single large V excision can be made for maximal tissue advancement

It is different from traditional lip fillers in that it does not require injectable material and the results are permanent.

Case Study

This young female had lost volume in the center of the lower lip from a prior bony genioplasty procedure. She desired more central lower lip fullness.

As part of other facial procedures the procedure was performed under general anesthesia. A wide V incision was made from the wet-dry line of the lower lip down into the depth of the vestibule. The width of the V at the wet-dry junction was 1/3 of the total lip width.

The mucosal flap was undermined superiorly living enough thickness so it had good perfusion. Once adequately released it news advanced superiorly closing in a Y configuration with a 1 cm length to the vertical climb of the Y. Closure was done with resorbable sutures.

The effects of the procedure was an immediate increase in vermilion fullness.

Key Features

• No visible external scars (incisions are inside the mouth).
• Permanent enhancement — no maintenance treatments like filler touch-ups.
• Can be performed on upper and/or lower lip depending on aesthetic goals.

Recovery & Results

• Swelling and mild discomfort are common in the early postoperative period.
• Most people return to normal activities within about 1-2 weeks.
• Results are typically visible soon after swelling subsides and are long-lasting.

Discussion

The key benefits of the V-Y lip lengthening are:

• No visible external scars (incisions are inside the mouth).
• Permanent enhancement — no maintenance treatments like filler touch-ups.
• Can be performed on upper and/or lower lip depending on aesthetic goals.

The ideal candidates for a V-Y lip lengthening/advancement procedure are:

• Want fuller, more projected lips without fillers.
• Seek permanent results with minimal external scarring.
• Have a central vermilion deficiency or a visible indent  in the horizontal lip line.

Contraindications for a V-Y lip lengthening are:

• Thin lips with minimal vermilion show
• Vestibular scarring from prior surgery
• Indwelling lip implants

How It Compares to Other Lip Augmentation Options

While the bullhorn (subnasal) lift and the V-Y advancement  are both central lip procedures the bullhorn lip lift primarily shortens the philtrum (nose-to-lip distance), whereas the V-Y focuses more on volume and forward projection without shortening the philtrum. Also the V-Y procedure is more versatile being able to be done on both the upper and lower lip while the subnasal lift is restricted to the upper lip only.

Dr. Barry Eppley

Plastic Surgeon