Q: Dr. Eppley, I wanted to inquire about how you perform an upper lip reduction as I am looking to get this procedure done for my naturally full lip. There seems to be a lot of variability in the shape of excision that surgeons use – some do an ‘infinity loop’ or ‘bikini top’ shape (two ovals joined by a central band), others do a trapezoid shape, and still others simply say they remove an undefined “wedge of tissue”. I assume the shape of excision impacts the final outcome, so am confused as to why there is such variability, and what approach you take and why.
A: The shape of the excision pattern in lip reduction does not really affect the outcome significantly. Lip tissue is very stretchy, unlike skin, so any pattern of excision will end up in a straight line that largely parallels the vermilion-cutaneous border. The most common excision pattern in lip reduction surgery is a crescentic pattern that is wide in the midline and tapers to the sides.
One should not become overly focused on the excision pattern. What is more important for the outcome is where on the lip it is located. The key to a visible lip reduction result is the removal of exposed dry vermilion rather than the wet flexible mucous of the lip.
Dr. Barry Eppley