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Mouth widening is a requested procedure when a patient feels it its disproportionately small/narrow to their face. The typical aesthetic measurement is where the mouth corners sit based on a vertical line dropped down from the pupil of the eye. When the mouth corner sits inside that line it is generally deemed that its width is disproportionately small or narrow. How far inside that line run terms of a linear measurement is ideally how much mouth widening is aesthetically needed.

Mouth widening is essentially a vermilion advancement done at the corners of the mouth by skin excision and vermilion relocation. While it is a conceptually straightforward procedure it is distinctly different from vermilion advancement on the rest off the lip by three differences. First it is located at the most movable portion of the lips where it is exposed to frequent stretching from mouth opening. Secondly it’s shape is not linear but v-shaped which exposes it to a greater risk of scar contracture and hypertyrophy. Lastly the mouth corner has the least amount of stretch capability of the entire lip as it is the thinnest and most attached due to the orbicularis muscle which wraps around it.

While the linear movements out to the ideal mouth width position may be desirable, such movements may be complicated if a corner of the mouth lift is needed as well. The extra added upward movement can place additional stress on the scar line. Thus when the combined mouth widening and corner of mouth lift are needed my recommendation is to go exclusively with the corner of the mouth lift…because some widening will naturally occur with the 45 degree angle of the corner lift. Two to three mms of mouth widening will naturally occur particularly when the vermilion advancement occurs into the lateral vermilion of the upper lip. (extended corner of the mouth lift)

Adverse scarring is always a concern with any type of corner of the mouth procedure.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

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