Can My Wide Central Upper Lip be Reduced?
Q: Dr. Eppley, I have a wide philtrum for a woman, it is too wide about an inch in between points. It is an anomaly and I think it is ugly. My sister calls them “bat-wing” lips. Can anything be done to reduce distance or even just smoothen the area. I would rather have a scar than this.
A: Thank you for your inquiry and sending your picture. The wide prolabium (the name given to the central upper lip between the philtral columns) poses challenges in reducing its width. While it is possible to remove a central strip of prolabial lip skin and the lower vermilion, it does create a fine line scar of which it is unknown whether the patient may interpret that as a good tradeoff. I have actually done it but that has been in highly motivated patients who were very clear before surgery any scar is better than what they had. This doesn’t mean you aren’t just then when the tradeoff is irreversible (you can’t put the tissue back and/ore erase the scar) one has to be unequivocal about that decision. That does mean that the scar may not heal well just that its location is not a more natural anatomic landmark like the philtral column.
The alternative approach is to build up the concave contour of the prolabial shape by adding a dermal graft layer underneath it. That would be a safer aesthetic approach albeit probably less effective in making the wide prolabial width less apparent.
Dr. Barry Eppley