Lip Asymmetry Correction

Q: Dr. Eppley, I am interested in lip asymmetry correction. My lips are thin and uneven and I would like to get it corrected. It’s so awful that I don’t want to have a picture of me taken with family. Five years ago I was diagnosed with a brain tumor. The surgeon operated through my eyebrow as the tumor was behind my eye.  This surgery left me with a mouth droop. I have attached pictures for your review and recommendations.

A: Thank you for sending all of your pictures. It is clear that the neurosurgery procedure created some facial nerve weaknesses which has resulted in your upper and lower lip asymmetries. The right upper lip is weak and does not lift up as much as the other side. Thus it rolls in and is smaller. The right lower lip depressor is weak and this makes the the right lower lip elevate (rather than being pulled down) when you smile.

While the facial nerves can not be made to work more normally, the lips have to be adjusted at the vermilion-skin junction to create more symmetric vermilion show. (lip asymmetry correction) These are known as vermilion advancements. The right upper lip needs a vermilion advancement to  create greater vermilion show to match the opposite side better. The same is needed for the lower lip to bring out the the vermilion edge to match better to the left side.

These vermilion advancements can be combined with a subnasal lip lift to shorten the distance between the nose and the upper lip at the same time.

All three lip procedures can be performed at the same time under local anesthesia as an office procedure.

Dr. Barry Eppley

Indianapolis, Indiana