Q: Dr. Eppley, I am a speech therapist, and while I would like to look into a possible vermilion advancement for my extremely thin lips (my upper lip is virtually non existent) I am worried about both the cost and the time to heal since I make a living using my lips to help my students and make a living.
A: For the pencil-thin upper lip, there is no better lip enhancement procedure than a vermilion advancement. It physically increases the vertical height of the lip vermilion and reshapes the cupid’s bow area and can be done for subtle or more dramatic changes to the lip. When done by itself, it is performed as an office procedure under local anesthesia. Its cost will usually run around $2,000. It does cause some moderate swelling but much of that is gone by a week after surgery. There are no restrictions after surgery but how that would impact someone performing speech therapy services is not clear to me. I suspect after one week you would be just fine, maybe two weeks at the longest.
Dr. Barry Eppley
Q: I always had a very thin upper lip with down turned corners. I have had dental implants (7) and a permanent bridge for my upper teeth recently. I noticed that my top teeth no longer show when my mouth is at rest and that my bottom teeth which hardly showed before are now quite visible when my mouth is relaxed and when I am talking. My dentist said this was due to aging (I am going on 51) I read an article by you on Lip Augmentation and was curious if I should be looking into a face lift or a lip procedure? I had my lips enchanced once (not sure what product was used, I am allergic to collagen) and the results were overly swollen and then within two weeks all was gone. What do you recommend?
A: The thin upper lip can be due to aging, a naturally smaller amount of vermilion tissue (pink part of the lip) or a combination of both. When you combine a naturally thin upper lip with aging and the need for dental implants (maxillary bone atrophy), you have the perfect setup for a very thin upper lip problem. When the vermilion is this thin, no injectable filler will provide a good outcome. While I think it is good that you tried the simple approach of a filler, one could have predicted that the results would not be good. But you have now at least proven that a surgical treatment is needed.
The way to get a fuller upper lip is to create more vermilion. This can be done very successfully through a lip advancement procedure. By removing a strip of skin above the lip and moving the existing vermilion upward, the upper lip will instantly and permanently become fuller. When this is combined with a corner of the mouth lift (through the removal of small triangles of skin above the downturned corners), you will have an instant change in the entire look of your upper lip and mouth area.
Dr. Barry Eppley