Q: I am interested in getting my upper lip made bigger. It is very thin and it barely shows at all. It is very embarrassing to have such a thin upper lip when so many women have nice full lips. I think a bigger lip would make me look better and more attractive. I want to get injectable fillers into it because that seems to work well for most people. But I don’t want to look like I have a big fat upper lip or have duck lips. How can I get injectable fillers without causing that problem?l
A: Most lip augmentation patients want a natural look. Very few want their lips too look like they have had something done, although some people do end up looking that way.The success of having a natural looking result in the upper lip with injectable fillers is based on how much native vermilion tissue (pink part of the lips) you have. The most common reason one ends up with the infamous duck lips is that too much filler has been placed into the lips. A more full upper lip can take more filler and still loko natural. But a thin upper lip can take very little without creating a pufffy look. This is because in the thin upper lip the injectable filler does more pushing out rathe than up because there is not enough tissue. When it comes to injectable fillers in athin lip like yours, you have to realize that you can never really end up with a nice full lip look that many women desire. You just don’t have enough vermilion to do it.
What you would more ideally benefit from is an upper lip advancement which directly treats the actual problem and is permanent. But because that involves a fine line scar, I would recommend that you first do an injectable filler treatment and see of you like the results. If you do, then just continue with periodic filler treatments. If you don’t, then you know that there is another option which can give a much fuller lip that is permanent.
Dr. Barry Eppley
Q: I am interested in shortening my upper lip. It is way too long. It is big enough that you could land a plane in that part of my face! I have read about the subnasal or bullhorn upper lip lift and that seems like a good solution to my problem. However, I am Hispanic and am concerned about the car under my nose. I have read about the Italian upper lip lift which does not create the scar under the middle part of the nose. Do you think this is a good option for me?
A: The only way to really shorten an upper lip is to remove a strip of skin, either across the subnasal base (under the nose) or across the top of the cupid’s bow. in the ‘Italian’ version, the select removal of skin from just under the nostrils will not significantly shorten the upper lip. That published article, which I have read and reviewed in the past, is quite frankly flawed. All of the patient results shown have the after photos with the head tilted upward which makes it look like the lip is shorter. (or the before photos have the head tilted slightly downward to make the lip appear longer than the afters) While I don’t think the authors deliberately meant to deceive the readers, the results do not support that it actually works. While having less scar under the nose is certainly appealing, the upper lip is not going to get shorter if the central part under the columella is not removed. That is the cornerstone of upper lip lifting. With your ethnicity and skin pigment, a scar anywhere is always a concern more of a concern than it would be in a Caucasian patient. It may be for that very concern that the Italian upper lip lift was devised.
Dr. Barry Eppley
Q: As a 59 year-old female, I am interested in the corner of the mouth lift. I had a facelift four years ago which did help the corners of my mouth to some degree but they need more attention. They are still downturned to some degree. Any info or photos would be appreciated.
A: Contrary to popular perception, a facelift has little effect on the corners of the mouth. In general, a facelift will not turn up corners of the mouth that are drooping down. It will have a very mild effect but nothing significant. This runs contrary to the fear that the corners of the mouth can be pulled way to the side and distorted if a facelift is ‘overdone’. Such is not the case. The mouth is a long way from the point of pull which is by the ears in a facelift. By the time the pull force reaches the mouth, it has little power left to much of anything. The downturned corner of the mouth must be attacked directly with a procedure right at where the problem is located.
The corner of the mouth lift is a simple office procedure done under local anesthesia. It involves the removal of a small triangle of skinjust above the downturned corner. In its replacement, the mouth corner is moved upward. It can be done conservatively or more aggressive depending upon the degree of downturning of the corners of the mouth. There is virtually no recovery other than some persistent redness at the corner of the mouth for a few weeks. This simple mouth procedure is powerfully effective.
Dr. Barry Eppley
One of the images highly associated with Valentine’s Day are lips…big, red and full lips. They are as synonymous with this day as much as chocolate and flowers. While big lips may be highly visible on this one day, they are actually sought out every other day of the year as well. Lip enhancement has been one of the popular office procedures in plastic surgery for nearly a decade and there is no sign of the demand slowing down.
Many women want fuller lips, some motivated by the look of Hollywood stars like Angelina Jolie which is more of an extreme look. But women of all ages seek lips that are larger, even if it just a little bit more. They want to add volume to their lips or improve the shape of their lips so that they can have more of an attractive pout. There are numerous injectable fillers that can make an instantaneous change, albeit temporary, and even some more surgical procedures and implants that offer a permanent result.
But plastic surgery technology aside, why is it that women want fuller lips? What is the deep-seated reason for this facial enhancement? Men do not ask for it and I have never had a single male request compared to thousands of female lip enlargements performed.
Some, of course, would say that bigger lips are an enticement to be kissed and therefore makes one more attractive. Kissing in not an exact science, although there is some interesting factoids about it. When you give your loved one a smooch, the majority of people tilt their head to the right. It requires six major muscles around the mouth to pucker up for a kiss. Our pupils dilate while we kiss, which is why we often close our eyes. A good sloppy wet kiss can transfer up to 100 million bacteria (not very romantic, but scientific fact nonetheless).
There is no question that lips are an erogenous zone for women in both appearance and function. Anthropologists tell us that a woman’s lips are a visible expression of her fertility. Studies have shown that a woman’s facial and sexual attractiveness is closely linked to her hormonal makeup during puberty and development. A woman’s estrogen levels helps maintain a youthful facial appearance in which the lips are fuller. Full lips are therefore attractive to men because they serve as marker of a woman’s health and fertility. They certainly seem to make women feel more attractive and sexy.
With this understanding, putting injectable fillers into the lips (or the more common application of lipstick) takes advantage of this innate biology. Bigger lips ‘fool’ men into thinking that a woman has more estrogen than she actually has and thus is more fertile and attractive. I have always said men are easy creatures to motivate…and this is one time again we don’t mind being fooled. Pucker up !
Dr. Barry Eppley
Q: I read with interest your article about upper lip lifting in the case of a retracted columella. I’m a 35 year old trangendered male who’s already undergone a feminizing forehead procedure elsewhere. My upper lip is VERY long and unattractive, but I’ve been told that, because of my nose, to shorted it I’d have to have grafts taken from elsewhere or even have my upper jaw moved, which needless to say I’m not crazy about. I have a short, upturned nose that I really rather like, but the long upper lip is a big issue and I’m curious if anything can be done without rib grafts or the like.
A: A subnasal lip lift can be done whether you have a retracted columella or not. The ability to do that fairly simple lip lifting procedure is not restricted by a retracted columella or decreased nasolabial angle. It may be aesthetically better to deal with the retracted columella at the same time however. That could be done in a variety of ways, all of which involve the insertion of some supporting graft behind the nasolabial angle. Instead of a rib graft, I would consider a dermal graft which does not need to be harvested from the patient. That could be inserted directly down to the columellar base from the a small opening after the bullhorn lip skin is removed and before final lip closure. But whether you even need that is unclear to me at this point. I would need to see see some lip photos to answer that question.
Dr. Barry Eppley
Q: My friends had fat taken from her stomach and put into her upper lip lines. Is this a procedure you do or recommend?
A: The search for a long-lasting injectable filler to the lips has naturally led to the use of one’s own fat. Even the thinnest person has a little bit of fat which can be harvested and recycled to the lips. In injecting fat to the lips, one accepts two caveats with its use. First, it is good for bulk filling (making the lips overall bigger) but is not useful for injecting into individual lip lines. It is not like synthetic injectable fillers which are injected using very small needles and can be selectively placed into a line as thin as the width of the needle. Fat is injected with a very large needle as the material is quite thick and does not come out in a true linear flow pattern. Secondly, its take or how well it survives is unpredictable. While the theory and expectation with its use is some or complete permanency, that outcome varies amongst different patients. One can not predict whether any one specific patient will have a long-lasting result. My experience has been to overfill (which can look really overfilled with the lip swelling that happens from the procedure), taking into account that there will be some fat resorption. By three months the size of the lip, and the amount of remaining fat, will then be permanent.
Dr. Barry Eppley