Q: Hello Dr Eppley. I wonder if there is a way to remove bumps on the temporal area just above my ears. They aren’t related to any medical problem but I want to have flat temporal sides. So is there a procedure to remove them or make them flatter? The other thing I want to learn is whether it is possible to increase length of lips. I’m not talking about lip augmentation, is there a way to increase horizontal length of lips? Thank you.
A: Temporal bulging above the ears, in most cases, is a reflection of the combined muscle and bone mass. The tail or back end of the temporalis muscle is what lies above the ear. I have done temporal narrowing (bitemporal reduction) through muscle resection and superficial cranial bone burring. That has worked quite well and is fairly easy to go through. You don’t really need the posterior attachments of the temporalis so it can be removed. The amount of temporal narrowing would be about 7 to 8mms per side.
The horizontal distance of the mouth (commssiure to commissure) can be surgical increased. It is done by a Y-V lengthening of the corners of the mouth. In essence, it is a lateral vermilion advancement through skin excision. While it can be technically done and is virtually painless afterwards, it does leave fine line scars at the edge of the vermilion. Whether that is an acceptable trade-off would depend on the nature of your skin and the amount of mouth widening that one would desire.
Dr. Barry Eppley