Shortening the Long Upper Lip
Q : I am 52 years of age and my upper lip seems to be getting longer. When I was younger my upper lip didn’t seem to be as long. When I smile I barely show any upper teeth at all anymore. Is there some form of lip surgery that can help me?
A: A long upper lip can develop in some patients due to the natural process of aging. The upper lip can literally lengthen due to shrinkage of the vermilion (pink portion of the lip) which gets smaller and actually rolls inward. These age changes of the lip can be accentuated by tooth loss. Loss of lip volume combined with other falling facial features makes the skin portion (between the base of the nose and the vermilion) of the upper lip a bigger percentage of upper lip length.
There are two specific procedures for shortening the upper lip. Both involve removing skin in a horizontal fashion at either the top or bottom skin portion of the lip. The subnasal lip lift, also known as the bullhorn lip lift, removes skin from right under the nose and truly is a lifting procedure. Removing skin just above the pink lip line is known as a vermilion or lip advancement. This advances the pink part upward directly. Both result in fine line scars although the subnasal lip lift places the scar in a more hidden location in the crease under the nose.
While both of these procedures are effective at creating a slightly shorter upper lip, both will increase the amount of vermilion show. The subnasal lip lift is limited to increasing only the central pout of the upper lip with lip shortening. The vermilion advancement moves the entire pink portion upward from one corner of the mouth to the other.
Which procedure is best for any patient depends on the anatomy of their upper lip, specifically the shape and thickness of the vermilion.
Dr. Barry Eppley