Q: Dr. Eppley, I had a lip lift in early December 2017. The surgeon took out 7mm of skin in the center of the upper lip. And now it seems that the nasolabial area looks bigger and mouth corners look down turned. I would like to know if the Double Duck would be a good option for me, when can I get the surgery and if you could perform this surgery, how much would it be ?
A: Thank you for sending your pictures, particularly that of the preoperative markings. When this amount of skin resection is done with a flat inferior border in a subnasal lip lift, it can cause an apparent over corrected appearance to the central upper lip and the sides of the lip are left ‘behind’. This creates an upper lip central to side vermilion disproportion and can also cause a downturning of the corners of the mouth. (too much central lip pull)
A strategy to improve to improve your upper lip shape could include the following:
1) Extended corner of mouth lifts with lateral vermilion advancements
2) Subnasal scar revision to try and move the scar line inside the nostril on each side of the columella (this is really a modification of the Double Duck Lip lift procedure)
Dr. Barry Eppley