How Can I Augment My Thin Upper Lip?

Q: Dr. Eppley, I am interested in improving the appearance of the area above my lips and softening my lip lines. I am also interested in lip surgery or augmentation for my upper lip which is basically non existent now at the age of 51. Improved volume and symmetry in both the upper and lower lip is desired. I have been looking for a surgeon that has a specialization in this area. I was excited to see so many examples in the photo gallery. Looking forward to seeing what the possibilities are. I had two prior consultations wbut in the end did not feel they were the right doctors for me.

A: Thank you for your inquiry and sending your pictured. You have four aesthetic lip issues: 1) a very long upper lip with a lot of skin between the nose and the upper lip vermilion, 2) small vermilion height (pencil lip), 3) vertical lip lines (wrinkles) and 4) a larger but still small lower lip vermilion/size with central vertical lip lines

Because of the amount of nasal base/sill show I don’t recommend a subnasal lip lift. The upper lip vermilion advancement is better because it changes the entire vermilion from one side to the other and will also diretcly remove those lip lines in the zone of excision. Because of the central lower lip lines and to keep the lip size proportionate a 2mm lower lip advancement would be helpful as well. (see attached diagram)

While I believe pip advancements would be the only effective surgical lip augmentation method it does create fine line lip scars so one needs to be cognizant of that tradeoff.

Vertical lip lines are a very difficult problem to improve long term due to their dynamic cause (lip movements)  and occur almost exclusively in Caucasian females due to their thinner skin. The only treatment is laser resurfacing but I don’t recommend that at the same time as the lip advancements as it may make negatively affect the vermilion-cutaneous scar lines.

Dr. Barry Eppley

Plastic Surgeon