Should I Get A Vermilion Advancement After An Ineffective Subnasal Lip Lift?

Q: Dr. Eppley, Hello, I had lip lift surgery last June and the results are minimal. I feel like the look hasn’t changed much, the philtrum is just a tad shorter. The surgeon has refused to take a few more millimeters off as he says my smile will be gummy. From the research I’ve done I believe my best bet would be vermillion border – upper – advancement. 

A: In a subnasal lip lift overcorrection can cause an A frame deformity (not a gummy smile) where the central vermilion is much fuller than the sides of the lip creating a vermilion height discrepancy in the shape of the upper lip. Whether you would benefit now with a secondary subnasasl lip lift, a secondary subnasal lip lift that also needs lateral vermilion advancements or converting to a total vermilion advancement requires seeing some pictures of your lips to make that determination. 

The total vermilion advancement is typically served for very thin upper lips with little vermilion show, an upper lip that lacks any significant cupid’s bow shape or for the patient seeking an extreme lip augmentation effect. The reason being when you make a scar line cross the cupid’s bow, as profound as that aesthetic effect may be, you have to have a compelling reason for doing it.

Dr Barry Eppley

World Renowned Plastic Surgeon