Q: Dr Eppley, I am in need of help. I had upper and lower lip lift surgery about three months ago for my very thin lips. I am not happy with the result. It looked very off-center and cock-eyed from the beginning. I could see right after the surgery that it was not even or symmetric. My doctor told me that it was just swelling but I knew it wasn’t right. Now that the swelling has long gone down, it looks the same just not swollen. My doctor keep saying it will even out but I don’t see how this is possible. I think his drawings were off from the beginning. He didn’t measure anything and just eye-balled with a drawing pen. Can any type of revision improve the way the lips look? I have attached a picture for your review.
A: For the sake of proper terminology, you had a lip or vermiliona advancemeent, not a lip lift which is just a central upper lip procedure done from under the nose. Beyond those semantics, however, your picture shows unnatural-looking lips for a variety of reasons. This would include the following; upper and lower lip asymmetry due to the cupid’s bow of the upper lip being off center and the left lower lip vermilion being vertically shorter than the left, the peaks of the cupid’s bow are too sharp (pointed), the tail ends of the lower lip vermilion into the mouth corners tails off too sharply (not enough vermilion exposure) and the arch of the upper lip vermilion in mid-portion (between the corner of the mouth and the cupid’s bow) is a little too high. I believe the lips could be improved by making some vermilion and skin adjustments to all of these areas. This is precision work so precise markings with calipers under loupe magnification is essential. These lip advancement revisions could be done as an office procedure under local anesthesia.
Dr. Barry Eppley