Q: Dr. Eppley, I had lip surgery last year with an asymmetric outcome. My mouth even got smaller (horizontal) which is a problem. Another thing is, that I’d like to reduce the red part of the lip with white skin. Now I wanted to know upfront if a correction is possible and if it is possible to reduce about 2mm of the red lip. (but not from the lip inside)
A: What you have done were lip advancements, also known as vermilion advancements. (An upper lip advancement is also known as a gull wing procedure) Your mouth got smaller and probably a but tighter because the advancements were carried out to the very corners of your mouth at both the upper and lower ends, thus creating a scar line around the corners. Lip advancements should never be connected at the corners to prevent creating a circumferential scar contracture which acts like a drawstring around the mouth as it heals. This can be corrected by doing a scar release at the corners and advancing the mucosa back out. This will also increase the horizontal distance between the mouth corners as well.
I am certain what you mean by ‘reduce the red part of the lip with white skin’. I assume you mean sort of reverse lip advancement? If that is what you mean, that is not possible to do. While the vermilion of the lip can be brought out by removing skin, the reverse can not be done.
Dr. Barry Eppley