Background: The lips can be affected by several shape features that have either occurred naturally or are the result of aging. One undesirable aspect of the lips is when their corners turn down. While often developing as a result of aging being weighed down by falling facial tissues, some people have it naturally. Lip volume is very similar. Age can cause loss of vermilion show but it is very common to have naturally thinner lips.
Botox and injectable fillers are good treatments for both downturned mouth corners and thin lips but they are not permanent. Corner of the mouth lifts offer an effective and permanent solution but they technique must be done thoughtfully to avoid unnecessary and adverse scarring. Permanent lip augmentation by volume addition relies on fat injections whose amount of permanency is not always completely predictable but has less risk of complications compared to lip implants.
Lip enhancement often involves doing multiple procedures to get the best effect. Changing the level of the mouth corners and concurrently increasing lip volume is one example of a more comprehensive approach to lip reshaping.
Case Study: This female who had naturally fuller lips was bothered by the downturning of the corners and a smaller upper lip compared to the other. She was also going to undergo multiple other facial procedure of which one was buccal lipectomiess.
Under general anesthesia bilateral corner of mouth lifts were done using the pennant technique. The buccal fat pads were processed into an injectable emulsion and 3ccs of fat was placed into each lip.
One under appreciated potential benefit of corner of the mouth lifts is that they also have a minor mouth widening effect. This is a function of the laterally oriented triangle of tissue excision. Whether the patient wants a horizontal corner leveling or slightly upturned corners is a matter of personal preference.
1) Downturned mouth corners can be leveled or elevated by corner of mouth lifts.
2) Lip rejuvenation can be accomplished by combining lifting the corners and increasing lip volume by fat injections.
3) The fat for lip injections can be obtained if concurrent buccal lipectomies or perioral liposuction is being performed.
Dr. Barry Eppley