How Can I Improve My Lip Problems After A V-Y Mucosal Advancement?

Q: Dr. Eppley, Hi, I’m desperate to get some advice from Dr Eppley. I underwent an upper lip V-Y mucosal advancement in 2024 in the UK. I have been left with significant functional and aesthetic issues as a result. Unfortunately, the surgery was a disaster from day one. The doctor did not suture the mucosa up properly, and left large flaps of mucosa inside my mouth hanging down over my teeth. When I queried about this, he told me to come back and he would remove the hanging flaps, which I did. Even more unfortunately, more problems arose and persisted as time went on. Functionally, my speech and movement now feels very restricted, with a constantly tight/pulling sensation along the scar-line inside my mouth. As well as that, I appear to have developed a very strange double-lip appearance when making certain mouth and facial movements. The inner mucosa seems to bulge and hang down over my top teeth if I pucker my lips or open my mouth in an “O” shape, making for a very unsightly and strange appearance. I am absolutely desperate for any advice at all. If it’s not too much trouble, I’d be so grateful if Dr Eppley could take a look at my pictures and give me some advice, or alternatively if he wants me to have an official remote consultation, I am more than happy to do so. I’m just so desperate to improve my situation. I’ve been living with it for over 2 years now and it hasn’t gotten any better over time. It really affects my ability to work. I’d be very grateful for any help whatsoever, thank you so much.

A:Based on your pictures this appears to be very similar to a congenital double upper lip which occurs due to redundant mucosa behind the wet-dry line. The origin of yours, of course, is different and is obviously due to the V-Y advancement… although I am having a little trouble trying to imagine how that happened. I suspect it wasn’t a conventional V-Y procedure.

That being said, at least by looking at your pictures, I would think that a horizontal excision of the mucosal role may  provide some improvement.

Dr. Barry Eppley

Plastic Surgeon