Q: Dr. Eppley, I have a vermilion lip advancement a few years ago and am not too happy with the results. My scars are healed but it is too large which makes the distance between my nose and upper lip too close. My bottom lip is also too large that makes opening and stretching my lips difficult. Overall, my lips look unnatural and is too big for my face. My question is: is it possible to cut the vermilion again to bring it down making the size of the lips smaller and improve the shape? I don’t think a lip reduction will work because my vermilion will still sit to high. What would you recommend? Thank you.
A: Once skin is removed from the upper lip, whether it is from below the nasal base in a subnasal lip lift or above the upper lip in a lip advancement, there is no way to put the skin back. These are permanent lip enhancement procedures that change the skin-vermilion relationship by excision. The vermilion can not be moved back down, short of a skin graft which would look like a patch and be aesthetically worse than before.
Dr. Barry Eppley