How Can My Botched Upper Lip Advancement Be Improved?

Q: Dr. Eppley, Many months ago, you responded via Real Self regarding my botched gull wing lip advancement. The plastic surgeon also did a v-y advancement under the cupid’s bow.  It has ruined my cupid’s bow and my lips have taken on a very flat appearance. I’ve been to 3 plastic surgeons for consults and each one has told me that there is nothing that can be done to correct my problems.  You had mentioned on Real Self that you could remove tissue (not skin) to give me a cupid’s bow which would also help with the flat look that I now have.  Would you be so kind as to explain exactly what this tissue removal involves.  I am somewhat concerned about more scarring.  As of now I have scars (small) where the current cupid’s bow is.  If you change the cupid’s bow to a more pleasant look, wouldn’t I have additional scars. I just hope that you can explain the procedure a bit more and inform me about any additional scarring.  I have attached recent photos which are 6 months after the initial gull wing lip advancement. Thank you so much, and I look forward to hearing from you.

A: What you have, as you know, is a flat or absent cupid’s bow of the upper lip. This is due to a lack of an indentation or greater vertical skin between the normal peaks of the cupid’s bow. To create this normal feature of the cupid’s bow, a few millimeters of vermilion in a curved fashion needs to be removed between the height of the cupid’s bow. You already have a scar line at the skin-vermilion junction so the risk of more visible scarring is very low. How much the prolabial skin will stretch down is uncertain but this is the only lip revision treatment option.

Dr. Barry Eppley

Indianapolis, Indiana