Subnasal Lip Lift
Q: Dr. Eppley, I have had a bull horn lip lift. I think it makes my mouth a little bit “sad” as it only lifts in the middle and not the sides. My wish is to have a higher middle part to push down on the lower lip and make the middle line in the lips more straight again (The three arrows in the middle in the picture).
My secondary wish is to have the outer part of the upper lip a little bit bigger (the two arrows pointing downwards in my picture).
Would you recommend VY-plasty on the outer sides and fat transfer in the middle or some other technique?
A: Your result is exactly what a subnasal lip lift does and could have been predicted beforehand. To accomplish your two remaining upper lip goals, one technique is to drop the middle part of the upper lip by fat grafting through an injection method. Either that or a dermal-fat graft placed like an implant. The other option is an internal mucosal V-Y advancement. Raising the sides of the upper lip is far ore predictable with a vermilion advancement than an internal V-Y mucosal procedure.
Dr. Barry Eppley