Q: Hi Dr. Eppley, I don’t like the look of my mouth. Can you help me to look like every other normal people and to make my mouth so that it isn;t so big. Because now I look like a monkey. I really don’t like my look and nobody else likes it either. Please send me a picture if you can do something about me. Big thanks!
A: Thank you for sending your pictures and stating your concerns. What you are referring to is known as macrostomia. This is where the horizontal length of the mouth, from one corner to the other, is too long or wide. Technically, the upper and lower lips are too long but it is where they join (called the commissures) where the mouth width is judged. By standard anthropometric measurements (created largely from Caucasian study populations), the width of the mouth should not exceed a vertical line drawn down from the pupil of the eyes. While this is a measurement it has to be taken in perspective of the patients overall facial aesthetics to determine if it is really abnormal or bothersome. It can seen in your one frontal photograph that your mouth corners extend beyond this area.
An excessively wide mouth can be horizontally shortened through a procedure known as a commissuroplasty or corner of mouth tuck. While this is more commonly used in the treatment of the reverse mouth problem, microstomia (too small a mouth), it can be used to make a wide mouth more narrow. While this could easily reduce your mouth width by 5 or 6mms a side (reducing total mouth width by a cm.), there is a trade-off of a fine line scar that goes a short distance in the skin outward from the corner of the mouth. One has to consider this scar trade-off carefully.
Dr. Barry Eppley