Q: Dr. Eppley, I have a very small upper lip which is substantially smaller than my lower lip. I have had several consultations and the recommendations have ranged from injectable fillers, implants to a lip lift. I am confused by these different recommendations as there doesn’t appear to be a consensus as to the best thing to do. I have attached a picture of my lips for you to see and give me your recommendation.
A: As you have discovered there is a variety of lip enhancement procedures that approach making the lips more attractive in a variety of ways. In the end, they all have the same objective, making the vermilion of the lips more pronounced. (increased vertical height and fuller) Think of these procedures as minimally-invasive (non-surgical) to surgical. As a general rule, most patients should always start with injectable fillers because this treatment is the simplest and is completely reversible. What this tells you is whether the existing size of your vermilion can be adequately inflated to achieve the look you want. If it does, then you can ponder whether fat injections or implants may be a better long-term solution. If expanding the existing vermilion is inadequate or produces an undesired look (duck lips), then the location of the vermilion needs to be removed. This is where vermilion advancements and lip lifts have a role to change the vermilion-cutaneous junction and the amount of lip skin.
Dr. Barry Eppley