How Can I Fix My Downturned Mouth Corners After A Subnasal Lip Lift?

Q: Dr. Eppley, I recently had a lip lift which has turned out extremely unflattering, I would like a second opinion, to see what if any procedure can fix it, as I am avoiding being seen and dreading returning to work, I have chosen to not pursue a revision with my surgeon because I believe I may need a corner lift now and I do not believe he does them anyway and I don’t want to risk a second surgery not knowing what to expect and prefer a more experienced surgeon in this field. I know I probably cant have surgery for 6 months but I cant just wait around not knowing when, where, or how I am goin to fix this, and if I have a consult now we can plan a surgery and I can get filler or something in the mean time and then dissolve it before surgery hopefully. My mouth now appears to be very downturned at rest as apposed to horizontal like before my surgery, and my lift seems a lot in the middle and ends before the end of my lip especially on the left side. I look forward to hopefully hearing from you soon thank you for your time.

A: Thank you for your inquiry and sending your pictures. What you have is a classic A frame upper lip deformity from a subnasal lip lift. Such a lip lifting procedure mainly affects the central or cupid’s bow region of the upper lip. Its effects do not extend as far out as the outer lip or mouth corners. This occurs when the absence of significant lateral upper lip vermiliion show is not recognized beforehand. This is where the value of the Q tip lifting test before surgery can be helpful.

That being said you can never reverse a subnasal lip lift as the skin removal is permanent. It is true that there will be some relapse of the lift (up to 20%) within the first six months after the procedure but that never really changes the upper lip vermilion disproportion that is now present. That is treated by lateral vermilion advancements for the outer aspects of the upper lip to create a more harmonious vermilion fullness from one mouth corner to the other. (see attached imaging)

Dr. Barry Eppley

Indianapolis, Indiana