Can The Upper Lip Be Shortened Without Increasing Tooth Show?

Q: Dr. Eppley, I am soon going to undergo maxillomandibular advancement. I currently have an optimal amount of tooth show. In the post-op simulation, my philtrum lengthens a bit. I suspect this is due to the advancement vector being a little downward relative to my natural head position (which is about 6.5 degrees downward from the frankfurt plane). I am not yet certain this will look bad, but I have always had a strong dislike for long as well as convex philtrums. I am wondering:

1. Is it possible to shorten the philtrum without increasing tooth show? I find mixed answers when it comes to this.

2. Is it possible to turn a concave philtrum convex again, also without altering tooth show?

Depending on the effect of my maxillomandibular advancement on the philtrum, I may be interested in one or both of these.

I look forward to hearing your response.

A: In my experience 1) No and 2) No.

Dr. Barry Eppley

World-Renowned Plastic Surgeon