Q: Dr. Eppley, Can a corner lip lift combined with a subnasal lip lift bring about the same results as a gullwing lip lift if you want to try to do avoid as large of a scar at the vermillion border as possible?
How much can alar retraction be corrected in millimeters? If oyu have an exceptioally severe case is it possible to do two operations the same way if someone wants exceptionally large breast implants they can get implants the first go around and then have the skin stretch, then replace implants later with larger ones? In the case of the nostrils, is it possible that the first time will not fit a large enough graft but this can be replaced later on down the road after the nostrils have adjusted?
Is there a procedure that can correct masculine and broad shoulders for a female that wants a more petite upper body? Something like clavicle reduction?
A: A subnasal liplift combined with an extended corner of the mouth lift is a way to create a similar effect as that of the lip advancement procedure. (gullwing lip lift) The subnasal lip lift substitutes for placing the excision of skin across the cupid’s bow area. Lateral vermilion advancements brought inward from the mouth corners is still needed but they do not encroach onto the more visible and delicate cupid’s bow area of the upper lip.
Alar retraction is treated by the placement of alar rim cartilage grafts. They will create a several millimeters of correction. More significant alar retaction may need to be treated by the placement of composite skin and cartilage grafts to roll out the inner lining. (which is where the skin portion goes. This it is not like your breast implant analogy at all.
There is no operation to reduce wide shoulders. A bony reduction is not possible because that impinges on the moveable shoulder joints.
Dr. Barry Eppley