Posts Tagged ‘lip advancement’
Wednesday, January 30th, 2013
Q: Dr. Eppley, Hello! I found you searching the internet and I find your work great. I just can find information about recovery for lips enlargement for this kind of operation http://exploreplasticsurgery.com/wp-content/uploads/2009/01/lip-advancement-surgery-indianapolis-dr-barry-eplpey1.jpg .How long does it take for scars not to be visible anymore? Or how long it takes for it to be slightly visible?
A: Other than some moderate lip swelling, there usually is no bruising with lip advancement surgery. Patients report little to no pain as the upper lip will have some temporary numbness. So the recovery is very quick as there are no physical restrictions after surgery. The scars from lip advancements heal very quickly and are minimally visible in 3 to 4 weeks after surgery although that will be somewhat dependent on the patient’s age and the preoperative shape of the lip. (younger patients take a little longer than older patients) Full scar maturation is a process and one should anticipate that the final appearance of the scar is one of months and not weeks. As there will always be a permanent lip scar, one has to have a thin and small lip that justifies that trade-off. One can wear lipstick one week afetr surgery so scar camouflage is easily done through the scar maturation process.
Dr. Barry Eppley
Indianapolis,Indiana
Tags: dr barry eppley, indianapolis, lip advancement
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Friday, January 18th, 2013
Q: Dr. Eppley, I am a speech therapist, and while I would like to look into a possible vermilion advancement for my extremely thin lips (my upper lip is virtually non existent) I am worried about both the cost and the time to heal since I make a living using my lips to help my students and make a living.
A: For the pencil-thin upper lip, there is no better lip enhancement procedure than a vermilion advancement. It physically increases the vertical height of the lip vermilion and reshapes the cupid’s bow area and can be done for subtle or more dramatic changes to the lip. When done by itself, it is performed as an office procedure under local anesthesia. Its cost will usually run around $2,000. It does cause some moderate swelling but much of that is gone by a week after surgery. There are no restrictions after surgery but how that would impact someone performing speech therapy services is not clear to me. I suspect after one week you would be just fine, maybe two weeks at the longest.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, lip advancement, thin upper lip, vermilion advancement
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Saturday, January 12th, 2013
Q: Dr. Eppley, I have thin uneven lips due to an injury as a child. When I was seven years old I fell of my bike and split my face open on the concrete. I had a long laceration that ran from my lip down to the underside of my chin and now it is a long wide scar. My lips are naturally thinner but this scar as it crosses the lip also makes the lip uneven as well. Is there a surgery that could correct this lip step-off and in the process make them a bit fuller as well? I don’t expect Angelina Joile lips, but just some normal looking lips. I would appreciate any help you can offer me.
A: Mismatched vermilion-cutaneous edges along the lip line can be easily corrected by either reopening the lip vermilion and realigning the edges or doing a transposition of the edges through a small z-plasty scar revision. Making the lips fuller at the same time can most effectively be done by an upper and lower vermilion advancements. But whether that fine line scar along the lip lines is a good trade-off depends on how thin your lips are and if you have enough vermilion that a filling material or an implant may offer enough size change that would avoid the need for vermilion scars.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, lip advancement, lip scar revision
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Saturday, April 28th, 2012
Q: Dr. Eppley, I am thrilled about which intervention I have to have done to my lips. They are both thin and fillers give me a duck look. I can’t decide if a vermilion advancement or a V-Y plasty is the best for me. Thank you for taking the time to answer me!
A: Usually the vermilion advancement or lip advancement works best in very thin lips because they lack adequate vermilion height for exposure. The V-Y advancement is an internal mucosal roll procedure that primarily creates greater central lip pout and increased vertical lip length, in essence a greater effect on mucosa than the vermilion. They actually are quite different procedures on their effect on creating lip size and shape. The vermilion advancement is also much more versatile in shaping the cupid’s bow area of the central upper lip which the V-Y advancement can not do.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, lip advancement, lip augmentation, v-y mucosal advancement
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Sunday, December 25th, 2011
Q: Dr. Eppley, I had a gullwing upper lip lift two years ago. I am very unhappy with the resulting scar. The surgeon who did the procedure said that the scar would end up invisible…it did not. The scar sits 2mm above my vermilion line and is very indented so even if I try to cover the scar with lip liner and concealer it still shows. The surgeon cut very deep and used only eight sutures on the whole of the top lip. Please give me your honest thoughts and whether it can be improved by scar revision. I have attached a picture of my upper lip so you can see how bad the scar is.
A: Thank you for sending your pictures. I think without a doubt that the scar and the upper lip shape can be improved. The indentation is so visible because the natural shape of the white roll (where the skin of the upper lip and the vermilion meet) is everted not inverted. While the eversion of the white roll is lost in every lip advancement, it should be flat and not inverted. I suspect that deeper sutures were not used in the closure so that inversion resulted. In addition, I see no definition of the cupid’s bow of the upper lip, which is one of the main benefits that a lip advancement can achieve. In looking at your before pictures, I think you had the wrong lip enhancement procedure from the beginning. You would have been better served with a subnasal or bullhorn lip lift not a vermilion or gullwing lip advancement.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, lip advancement, lip lift, lip scar revision
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Sunday, July 17th, 2011
Q: Dr. Eppley, Hello I live in Europe and would like to do the lip advancement as an alternative to injectable fillers for permanent lip enhancement. But I would like to know where you do it and how much it costs?
A: Most lip (vermilion) advancements are done in the office under local anesthesia. Using initial infraorbital nerve blocks (like going to the dentist) and then followed by direct infiltration into the lips, the procedure thereafter is painless. If a patient prefers it can also be done supplemented by oral valium or Xanax or even IV sedation for a completely comfortable experience. It takes about 90 minutes to perform. The amount of vermilion advancement is determined by the patient prior to the numbing by making marks using calipers and a fine marking pen…and then having the patient approve the amount of lip increase with a mirror. There is some mild lip swelling afterwards and very minimal discomfort. Patients generally do not take any pain medication afterwards. For patients that are geographically close to me, I place tiny 7-0 size sutures that are removed 10 days after surgery. For my far away patients, I use a fine 6-0 dissolveable sutures and skin glue so no return is necessary for suture removal.
For the properly selected patient, lip advancements are a powerful lip enlargement procedure that produces a permanent result.
The total costs of the procedure are around $ 3,500.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, lip advancement, permanent lip enlargement, vermilion advancement
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Tuesday, May 31st, 2011
Q: I had a lip lift performed several months ago. I have attached some before and after pictures. As you can see the incision isn’t on the borderline and its now indented and puckers. I’m really so unhappy and paranoid with the scar and am now so desperate for revision. I was so impressed with your website you actually used 48 stutures on the womens top lip, I did count  In my surgery the surgeon only used 8 stiches. as you can see in the pics. In you lip lift proceedure do you actually cut right through all the skin lares? Only when I had my lip lift surgery the surgeon did numb my upper lip with a dental block, but the pain was still horrendous. Also as I wasn’t having my bottom lip operated on it wasn’t numbed, therefore I actually felt my actual top lip resting (flipped over) onto my bottom lip. Is this normal procedure to actually sever top lip so completely that it is able to flap over like that? What I’m asking really is do you cut so deep and if so do you place internal stiching of any kind? Its all a bit complex for me but I really need to know the whole procedure. Thank you in advance and looking forward to your reply.
A: Thank you for sending your pictures. Technically, what you had done is known as a lip advancement or vermilion advancement. A true lip lift is done with an incision under the nose. I prpare patients with a dental block first and then inject directly into the upper lip once one is numb. It should be a virtually painless procedure to go through after the dental blocks and local infiltration. During the procedure, only full-thickness skin is removed and no underlying muscle. There is a two -layer closure with some deeper sutures for the dermis and fine sutures for the skin closure.
Your scar is a bit wide and indented compared to a typical result lip advancement result in my experience. That could easily be improved and a little more skin removed and more of a cupid’s bow made to get a better result.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dr barry eppley, indianapolis, lip advancement, lip lift, vermilion advancement
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Friday, April 1st, 2011
Q: Hi there, I was interested in your lip lift procedure and wondering if you did fat transfer to the face for reshaping/volumizing, and a butt lift using fat transfer. I’ve been researching for several months and I’m ready to have it done, but I’m wanting to find the right surgeon for me.
A:I do a lot of fat injection surgery, most commonly to the face for volumetric enhancement and to the buttock for augmentation, otherwise known as the Brazilian Butt Lift. Fat transplantation by injection is a really exciting approach for numerous face and body contour problems even if its ultimate survival is not always assured. The exact technique for fat preparation varies by surgeon and there is no absolute agreement as to how it should be done. I use a fat concentration technique and then mix it with PRP and Acell Particles to enhance survival and volume retention. These are by far the most common recipient locations. The key is whether one has enough fat to harvest which is an issue for the buttocks and not the face.
Lip ‘lifts’ can be done as either a subnasal lip lift or a vermilion advancement depending upon the shape of the upper lip and the patient’s scar tolerance. Please send me some photos of your lip for my assessment. Both approaches can be very successful when properly done. Vermilion advancements produce the most dramatic change in lip size and shape. True subnasal lip lifts are more limited in how they change the shape of the upper lip.
Dr. Barry Eppley
Indianapolis Indiana
Tags: brazilian butt lift, dr barry eppley, facial fat injections, indianapolis, lip advancement, subnasal lip lift
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Tuesday, December 21st, 2010
Q: My main questions are in regards to the permanent lip options available to me. I could send you my picture so you can get a better idea. I have tried a few injectables and am not really happy with results in terms of size and longevity. I understand there are also options for implants vs. v-y surgery. (most permanent?) What are the complications, risks and costs of these options. Also, do you use Alloderm or Gortex implants, or is it based on cases by case basis. What is the longevity of Allodem?
A: I choose which permanent lip enhancement option on a case to case basis. That could include lip advancement,lip lift, v-y advancement or Advanta lip implants. There are different reasons for using any of these based on the existing size and shape of one’s lip. Pictures would be of great help in determining what may be best for you. Alloderm has not proven to be a permanent lip implant material so it is no longer used.
If you have not had good success with injectable fillers, then the concept of putting in any permanent material will likewise be unsuccessful. Your lips are not big enough or have the right shape to merely be ‘inflated’. This would indicate that you need more vermilion exposure through some form of excisional procedure such as a lip advancement or possibly a tissue shifting approach with an internal V-Y advancement.
Dr. Barry Eppley
Indianapolis Indiana
Tags: advanta lip implants, dr barry eppley, indianapolis, lip advancement, lip lift, permanent lip enhancement, 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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