Q: Dr. Eppley, I’m 25 years old and four years ago I underwent orthognathic surgery (lower jaw advancement) and a chin osteotomy because the lower part of my face was receded and short. In terms of proportions the surgery has been a relative success. However, since then my oral commissures (mouth corners) have been pulled downwards and are not in line with the middle part of my lips. To give you an idea, the mouth corners go as low as the gum area of my bottom teeth. The mentalis was re-suspended after surgery so perhaps that’s why the middle part of my lips has not been affected. As you can see the rest of my face has not yet aged so this pulled down mouth corners look very unnatural and give the illusion that my upper lip is very long whereas the actual distance between my nose and upper lip is normal.
I was wondering if there’s a solution for this? Something that can pull my mouth corners up to be in line with the middle part of my lips?
A: The only way that the corners of the mouth (and the sides of the lips) can be pulled up is through vermilion advancements and/or corner of the mouth lifts. This works by removing skin and moving up the vermilion border. This does create a very fine line scar at he vermilion-cutaneous junction which actually does better in men than women due to hair-containing skin.
Dr. Barry Eppley