Posts Tagged ‘corner of mouth lift’
Monday, October 31st, 2011
Q: Dr. Eppley, I am a 48 yr old female. Over the past few years, the corners of my mouth have started drooping, to the extent that I am often asked if something is wrong (it appears that I am frowning all the time). I don’t want major surgery, and in researching options for my issue, the corner of the mouth lift seems to be a possibility. One additional note; the droopiness is more pronounced on the right side. I have attached some photos for your assessment.
A: Downturning of the corners of the mouth is a common aging issue. The lip line is the union of the upper and lower lip at rest when one is not smiling or has any oral animation or movement. It is like a level and one should be able to draw a straight line between the two end points to create a straight lip line. The corner positions of the lips or the commissures have a great influence on the appearance of the lip line. You don’t want them upturned (Joker look) or downturned (frowning or sad) as it gives one a static expression that is not favorable. Corner of the mouth lifts change the location of the commissures through a very small amount of skin resection and lip vermilion repositioning. It is a relatively simple procedure that can have a dramatic effect. It can be done under local anesthesia as an office procedure. It does the one thing that many people think a facelift does but does not. A facelift can not change the corner of the mouth because its pull is too distant. Changing the corner of the mouth must be done by direct excision.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: corner of mouth lift, dr barry eppley, indianapolis
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Thursday, August 4th, 2011
Q: I am interested in the corner of the mouth surgery to lift up my downturned and sad looking mouth. What are the risks, recovery time, and success rate of this procedure? Is the procedure an office visit? What number of follow up procedures are required?
A: The corner of the mouth (COM) lift is an office procedure done under local anesthesia. Dissolveable sutures are used so no return visit is necessary for out of town patients. I would say there is really any true recovery, just some redness in the corners of the mouth for several weeks and time to let the scars fade. There are no dietary or oral hygiene restrictions afterward. It is always a successful procedure as the corners are always leveled out rather than downturned. The key is not to overdo it so the corners are turned up or give someone a ‘joker’s smile’. There will be a very fine line scar that emanates out from the corner of the mouth about 5 to 7mms, but it is very small. Sometimes there may be a need or it is of benefit to do some other minor procedures around the corners of the mouth. (e.g., fillers to marionette lines) This is why it is a good idea for me to see a picture of your mouth in a non-smiling position to determine if this is the corner of the mouth lift procedure for you.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: corner of mouth lift, dr barry eppley, indianapolis
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Monday, February 14th, 2011
Q: As a 59 year-old female, I am interested in the corner of the mouth lift. I had a facelift four years ago which did help the corners of my mouth to some degree but they need more attention. They are still downturned to some degree. Any info or photos would be appreciated.
A: Contrary to popular perception, a facelift has little effect on the corners of the mouth. In general, a facelift will not turn up corners of the mouth that are drooping down. It will have a very mild effect but nothing significant. This runs contrary to the fear that the corners of the mouth can be pulled way to the side and distorted if a facelift is ‘overdone’. Such is not the case. The mouth is a long way from the point of pull which is by the ears in a facelift. By the time the pull force reaches the mouth, it has little power left to much of anything. The downturned corner of the mouth must be attacked directly with a procedure right at where the problem is located.
The corner of the mouth lift is a simple office procedure done under local anesthesia. It involves the removal of a small triangle of skinjust above the downturned corner. In its replacement, the mouth corner is moved upward. It can be done conservatively or more aggressive depending upon the degree of downturning of the corners of the mouth. There is virtually no recovery other than some persistent redness at the corner of the mouth for a few weeks. This simple mouth procedure is powerfully effective.
Dr. Barry Eppley
Indianapolis Indiana
Tags: corner of mouth lift, dr barry eppley, indianapolis, plastic surgery of the lips
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Sunday, November 28th, 2010
Q: I have drooling from the corners of my mouth and its embarrassing. I am 73 years old and have not had a stroke and I am still working everyday. What can be done for this corner of the mouth drooling problem. It was also occasionally get red and sore and painful. When this happens, it takes a fair while until it finally gets better. I have tried all sorts of antibiotic creams and salves but nothing seems to be that effective. I have read about a procedure called the corner of the mouth lift that removes the overhanging skin. Do you think this will help?
A: Downturning of the corners of the mouth, combined with aging which creates a skin overhang, creates a gutter effect at the corner of the mouth. This is the perfect setup for a runway for saliva. This problem can be further magnified with one has overclosure of their lower jaw due to a loss of teeth or ill-fitting dentures. This overclosure causes a lower lip inversion which makes the drool problem at the corner of the mouth worse. Localized infection at the mouth corners can happen due to the chronic wetness of skin that is not normally so like the lining inside the mouth. This is known as angular cheilitis. Topical steroids and antifungals can help but a change of the anatomy is more effective.
The corner of the mouth lift can be really helpful for this problem as it removes the skin overhang and lifts the mouth corner. This eliminates much of the spillway problem. There is a trade-off of a small scar that tails away from the mouth corner but this is not usually a significant cosmetic concern.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: angular cheilitis, corner of mouth lift, dr barry eppley, indianapolis, plastic surgery
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Monday, November 8th, 2010
Q: Hi Ii am 22 years old and would like to undergo a rhinoplasty procedure with you since I have read some very good things about you. I am aware about the rhinoplasty surgery and I don’t need further information on that procedure. But I was wondering if you can fix another facial problem. The distance between the mouth and the nose is very good. But when I close my mouth its like fat or muscles pile up and that makes the area between my mouth and the nose look big, even though it is not. In addition, the corners of the mouth droop down and give me a sad face appearance. Is there any surgical techniques to fix these problems?
A: The upper lip fullness to which you refer seems like a natural phenomenon . If you open your mouth, the upper lip thins as the nose moves upward and the upper lip stretches downward over the teeth. When you close your mouth, the ‘accordion’ shortens and the upper lip gets fuller again. This seems to be a normal tissue reaction and there is certainly nothing that can be done to surgically change the thickness of the upper lip at rest.
The downturning of the corners of the mouth, however, is a different issue. That can be changed through a simple procedure known as a corner of the mouth lift. A small triangle of skin is removed just above the downturned corner to bring it back to a more horizontal lip level.
Dr. Barry Eppley
Indianapolis Indiana
Tags: corner of mouth lift, dr barry eppley, indianapolis, plastic surgery
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Monday, September 20th, 2010
Q: I always had a very thin upper lip with down turned corners. I have had dental implants (7) and a permanent bridge for my upper teeth recently. I noticed that my top teeth no longer show when my mouth is at rest and that my bottom teeth which hardly showed before are now quite visible when my mouth is relaxed and when I am talking. My dentist said this was due to aging (I am going on 51) I read an article by you on Lip Augmentation and was curious if I should be looking into a face lift or a lip procedure? I had my lips enchanced once (not sure what product was used, I am allergic to collagen) and the results were overly swollen and then within two weeks all was gone. What do you recommend?
A: The thin upper lip can be due to aging, a naturally smaller amount of vermilion tissue (pink part of the lip) or a combination of both. When you combine a naturally thin upper lip with aging and the need for dental implants (maxillary bone atrophy), you have the perfect setup for a very thin upper lip problem. When the vermilion is this thin, no injectable filler will provide a good outcome. While I think it is good that you tried the simple approach of a filler, one could have predicted that the results would not be good. But you have now at least proven that a surgical treatment is needed.
The way to get a fuller upper lip is to create more vermilion. This can be done very successfully through a lip advancement procedure. By removing a strip of skin above the lip and moving the existing vermilion upward, the upper lip will instantly and permanently become fuller. When this is combined with a corner of the mouth lift (through the removal of small triangles of skin above the downturned corners), you will have an instant change in the entire look of your upper lip and mouth area.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: corner of mouth lift, dr barry eppley, indianapolis, lip advancement, plastic surgery, thin upper lip
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Tuesday, August 24th, 2010
Q: How do you do mouth widening? I have a relative that is scheduled for that procedure and we are hesitant to do it. We have never heard of such a thing. How safe is the procedure? Thank you for any information that you can share with me.
A: The concept of making one’s mouth wider is possible but very rarely done. I can only assume that your relative has a small horizontal width to their mouth (small mouth) and wants it to be extended further horizontally.
Such an operation is possible by using the principles of commissure creation or modification. Known in plastic surgery as a commussuroplasty, the corners of the mouth can be either shortened (closed down) or opened up. (made wider). To make the mouth wider, a modified isoceles triangle of skin is removed out to the distance you want and the inner lining of the lip (mucosa/vermilion) is advanced out and sewn to it. (a Y-V advancement) This relatively simple procedure will make the mouth wider but does so by leaving small scars at the corners of the mouth at the junction of the skin and the lip tissue. If not overdone too much, it can definitely make a difference and look fairlu natural. Such a technique is used in the more commonly done corner of the mouth lift, where downturned corners are turned up and made more horizontal to get rid of frowning or a downturned smile.
Conversely, the reverse can be done to make a wide mouth small. (a V-Y advancement) This leaves a more noticeable scar in its wake as the lip lining is moved further inward.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: commisuroplasty, corner of mouth lift, dr barry eppley, indianapolis, making a small mouth wider, making a wide mouth smaller, mouth widening, plastic surgery
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Saturday, August 14th, 2010
Q: I have been suffering from angular cheilitis subsequently leading to cutaneous candidiasis and sometimes even a secondary bacterial infection for the past 18 months. If my face starts to sweat I immediately dry off my face but am mortified when I awake to realize saliva has pooled in the little cracks in the corner of my mouth. Despite my best efforts, I cannot always keep this area dry.
My dentist told me that it was due to a parafunctional habit and anatomical variation. So I changed the one thing I could control and stopped licking my lips. However, since then my best efforts barely keep this at bay and last week I had a tiny pimple in that area, the skin broke open, and you know the rest, the lovely normal flora became and opportunistic pathogen eating my face away, looking unsightly, and cracking my skin open if I accidentally open my mouth too far.
People think I am crazy for wanting surgery and I fear the opinion of female family members due to the new age stigma of getting plastic surgery too young. This is not for vanity unless you count wanting to be kissed vain, and when I have this crap on my face even I do not want to kiss me! Or look at me for that matter, not to mention how painful and itchy this can be and how long it takes to heal!
I have read that there is a possible surgical treatment for angular cheilitis. What is it and do you think it will be helpful for me. I am just looking for a permanent solution to this nasty mouth problem.
A: Angular cheilitis, also called perleche, is an inflammatory mucositis at the corner of the mouth and usually affects both sides. It presents as deep cracks or splits which may bleed when the mouth is opened widely. Why it occurs is not known precisely. Chronic wetness at the corners is the incipient event and that is most understandable in the elderly edentulous population who experience a loss of vertical dimension due to loss of teeth, thus allowing for over-closure of the mouth. This creates a spillway for saliva and chromic wetness in the mouth corners. Yet I have seen it just as often in younger patient who have a normal angulation of the corner of the mouth.
For those patients that have exhausted all medical treatments for angular cheilitis, surgical treatment is possible. When the corners of the mouth are sufficiently downturned, I have found a corner of the mouth lift to be helpful to change angulation and eliminate that spillway effect. In younger patients with a normal horizontal angulation, a resection of the mouth corner mucosa with mucosal advancement can be done. Sometimes this can include skin as well. The theory here is that the tissues are chronically infected and it is removed. I have seen improvements of the condition with both approaches.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: angular cheilitis, corner of mouth lift, dr barry eppley, indianapolis, plastic surgery, surgical treatmenmt of angular cheilitis
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