Subnasal Lip Lift Techniques
Q: Dr. Eppley, Can the subnasal lip lift be done as an upper lip lift with a no scar suspension as an in-office procedure? The upper lip is shortened via an intranasal incision and suspension suture that elevates the upper lip and anchors it to the anterior nasal spine. I would like this technique if possible.
A: That technique you have described for a subnasal lip lift is not a good one for two reasons. First, putting the incisions inside the nose eliminates the natural nasal sill, making it look abnormal. Once the nasal sill is lost it can not be reconstructed. Secondly anchoring it to the nasal spine or any deeper tissues will affect your smile, making it stiff and abnormal. Such suturing interferes with the normal sphincteric movement of the orbicularis muscle as well as may interfere with the excursion of the upper lip in smiling.
A subnasal lip lift is a delicate technique that requires prevision in its execution to avoid asymmetry, poor scarring and smile alterations. It is important to not over resect skin as it can not be put back. My general rule is to not remove skin in the range of 25% to 33% of the natural philtral length.
Dr. Barry Eppley