How Can I Restore Lip Shape and Tightness After Cheek Implant Removals?

Q: Dr. Eppley I had a well done lip lift very happy with the result. Several months later, another surgeon recommended custom cheek and jaw implants to address facial bone asymmetries. Over the following year, the implants were placed, revised, and ultimately removed. Each surgery involved incisions through my upper gumline.

Since those procedures, my upper lip has changed dramatically. The inner mucosa feels shortened, tight, and scarred, causing the lip to curl inward rather than outward. I have difficulty closing my mouth comfortably and feel there is not enough internal lining left to properly support the lip. The philtrum also appears longer than it did after my lip lift, despite increased tooth show.

My primary concern is restoring the upper lip’s function and natural outward roll. I do not believe filler would adequately address the issue because the problem seems related to internal tissue deficiency and scarring rather than volume loss. I have also been told that a V-Y advancement is not be feasible because the available mucosal lining appears significantly shortened almost gone.

I have attached photos taken about eight months after my lip lift, before the implant surgeries. They show my fully healed result without filler and demonstrate how much the lip has changed since the repeated upper gumline incisions. I am open to grafts, flaps, scar release, tissue repositioning, vestibuloplasty, or other reconstructive options that may help restore internal lining, reduce tightness, and improve lip position and function.

I have tried to consult other surgeons but alot of them do not know how they can help me. Im very desperate in need for help.

I am not looking for my orginal lips back but just any type of improvement.

A: This is a very difficult problem to improve so it is good that your goal is not complete lip restoration as that is not possible. In terms of improvement you have to separate shape vs function.

Improving lip fullness can only be done by V-Y advancements, which despite having been said to not be possible, remains unproven to me that it can not be done.

Lip mobility is due to scar contracture of which vestibular releases and Alloderm grafting has proven useful in my experience.

Whether both can be done simultaneously is ideal but whether the tissues will permit it remains to be evaluated.

Dr Barry Eppley

Plastic Surgeon