Enhancing the shape and size of the upper and lower lips can be one of the most powerful gender facial changes. Though small in size their impact on gender identification is significant. A variety of surgical and non-surgical lip augmentation procedures exist. The most common form of lip augmentation done is with the use of injectable fillers. Besides being temporary its effectiveness is based on having enough vertical vermilion height to allow a visible volume increase without having excess horizontal protrusion. (duck appearance) Fat injections can also be used but they has such a poor history of successful survival in the lips that they are the least commonly used method of lip augmentation.
This same issue applies to lip implants where their effectiveness is dependent on having adequate vermilion and a good Cupid’s bow shape initially. These are very soft solid silicone implants that have smooth surface that pass easily into and out of the tissues. But to convert the male lip to a more feminine appearance, surgical lip augmentation methods can be more effective and permanent.
Subnasal Lip Lifts
There are four surgical lip augmentation procedures available; subnasal lip lifts, vermilion advancements, V-Y mucosal advancements and corner of mouth lifts. When the vertical distance between the base of the nose and the upper lip is long (which many men have) and the sides of the upper lip vermilion have adequate height, the subnasal lip lift is ideal. By removing skin from under the nose the upper lip skin distance is shortened and the Cupid bow area looks fuller and more upturned.
When the upper lip is very thin from corner to corner the preferred procedure is a vermilion or upper lip advancement. Lip advancements change the location and shape of the vermilion border and creates the most powerful and permanent method to enhance the size of a once thin male upper lip. It is the only procedure that can make a more pronounced Cupid’s bow when doesn’t exist. The very fine line scar along the vermilion-skin border heals very well. It can also be equally applied to the lower lip. When vermilion advancements are done in both the upper and lower lip concurrently the mouth area is dramatically feminized.
V-Y Muscosal Advancements
Another less frequently used method of lip augmentation is an internal approach the leaves no external scars lines. By rolling out the internal wet mucosa of the lip in a specific V-Y form of advancement, the underside of the lip is more exposed making the lips bigger. This only really works well of the patient already has an adequate amount of dry vermilion height.
Corner of Mouth Lifts
Downturned or dropping corners of the mouth, in any gender, does not offer a pleasing appearance. The most effective and permanent procedure is a corner of the mouth lift. The historic method for doing so leaves unfavorable scars beyond the vermilion-skin junction and has been replaced with a pennant excision technique. This allows the mouth corner vermilion to be placed more level or upturned while keeping the fine scar line at the preferred skin-vermilion edge around the entire corner of the mouth.
Dr. Barry Eppley