How Can I Fix My Lip Incompetence and Shorten My Philtral Length?

Q: Dr. Eppley, I was wondering issues regarding lip incompetence and other facial features. 

I think I got lip incompetence due to allergies or maybe dust mites? 

I want to fix my lip incompetence because I have breathing problems and I cannot breathe through my nose, only through my mouth. 

I also wanted to know if there’s any procedures to reduce one’s philtrum length? Is it scar-free? 

I sent you a front and side profile to examine. 

Thank you so much for your assistance.

A:Thank you for your inquiry and sending your pictures to which I can make the following comments:

1) Your lip incompetence is caused by your lower jaw and chin. There is no enough bone support for the lower lip. It has nothing to do with allergies, it is an anatomic problem. The only way to effectively treat it is with either a major lower jaw advancement procedure or an isolated sliding genioplasty procedure. (see attached imaging)

2) The distance between the base of the nose and the upper lip can be reduced by the well known subnasal lip lift procedure. This results in a very well concealed scar line under the base of the nose. While not scar-free the more important tradeoff to consider from this procedure is whether the increased fullness of the upper lip would be acceptable. (see attached)

Dr. Barry Eppley

Indianapolis, Indiana