Can I Get A Subnasal Lip Lift Without Cutting The Muscle?

Q: Dr. Eppley, I’m interested in a lip lift with lip reduction. Do you perform it with muscle cut under the nose too? My upper lip is already to forward and I want to avoid making it even go more forward after a lip lift.

I naturally have an upper lip that is somewhat projected forward(also had silicone injection years ago), and I’m concerned that a lip lift might increase that projection or cause the lip to appear overly everted.

I’m specifically looking for a subtle and natural result — with a shorter philtrum and better tooth show, but without making the upper lip stick out more.

Could you please let me know if your technique is muscle-sparing or including cutting,and if it avoids adding forward projection?

A:In a subnasal lift lift I never remove underlying orbicualris muscle. This not only deepens the nasolabial angle in an unfavorable manner but often causes prolong difficulty with smiling and other lip motions. Thus it is a skin only procedure in my experience.

The logic of why some surgeons remove muscle in the procedure is that  it limits any postoperative relapse. While there is merit to that relapse prevention the trade-offs are not worth it in my opinion. Long term follow up has demonstrated that most primary subnasal lip lifts, depending upon how much skin is removed, will within the first six months undergoing 10 to 20% relapse of length. But this to me as a better problem then issues that can occur with muscle removal in the procedure.

Dr. Barry Eppley

World-Renowned Plastic Surgeon