Your Questions

Q: Dr. Eppley,  I recently (3 weeks ago) had a lip lift which I am very unhappy with. I have attached the before and after pictures. What I expected with the lip lift was to have more lips all through out the upper lip, not only in the middle where the cupid bow is (looks like a chipmunk). At the same time I wanted to reduce the length between the lips and the nose. I always had thin lips and always wanted more fuller lips , upper and lower lip with shorter distance between the lip and nose. With the lip lift , I thought the lip would of been less thin on top and would of done fat transfer to have some fullness afterward.

A:  Thank you for sending me your before and after photographs. There must have been a miscommunication before surgery because your lip lift did exactly what it is supposed to do and can do…lift up the central third of the upper lip. It can not change the whole upper lip vermilion as the skin is only removed from the central third at the nasal base. The only lip enhancement procedure that can change the entire lip vermilion is a lip advancement where skin is removed alone the vermilion-skin junction from one corner to the other. That is a tremendously effective procedure but does produce a very fine line scar along the vermilion-cutaneous. That is why a lip lift is usually chosen for men although there is nothing inherently wrong with a lip advancement for men either.

You actually have a good early lip lift result. But although the operation may have been done appropriately, it may not have been the right operation for you as it turns out.

Lip lifts are irreversible, meaning you can’t put back the subnasal skin that has been removed. Your options at this point are the following:

1) Give the lip lift a few months to settle and relax because they all stretch out often up to 25% or more over time. Then decide what to do.

2) Jump in early and do lateral upper lip vermilion advancements (leave the cupid’s bow  alone obviously) to make the lip vermilion more even and lifted across the lip. You can do fat injections at the same time but you may not need to do so with lip advancements.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am interested in having the upper and lower lip advancement like the woman featured on your site who found that fillers did not make her lips large enough. I have this same problem. I am also interested in the price.

A: In thin lips, injectable fillers often produce unsatisfactory results as there is not enough vermilion (pink part of the lips) to fill. Without enough vermilion, the injectable filler material can only push outward rather than upward as well. This creates an abnormal looking often call ‘ducklips’. If one’s lips are very thin and injectable fillers have failed to produce a good look, the lip advancement procedure is an alternative. By physically moving the vermilion border up (upper lip ) or down (lower lip), the size of the lips is increased. Usually lip advgancements are done as an office procedure under local/oral sedation. The cost is $2,00 0 per lip or $3,500 for both lips. Because they permanently change the amount of exposed lip vermilion, they can have a powerful effect on the appearance of lip size. While lip advancements are the most effective procedure for making bigger lips out of thin ones, there are some minor trade-offs. There will be a resultant fine line scar at the junction of the skin and the vermilion which for most patients is barely perceptible. But it is important to know that there will be a residual scar, fine as it may be.

Dr. Barry Eppley

Indianapolis, Indiana