Q: Dr. Eppley, My upper lip is big and hangs over my teeth. i am looking for a lip lift. I am in my mid 50s Am I good candidate for it. Will my upper lip look bigger or the same.
A: An upper lip lift, presumably through a subnasal incision location, would produce only a minimal amount of lip lift as it relates to improving tooth exposure. It would make the central part of the upper lip look bigger. If you are happy with the current size of your upper lip, a subnasal lip lift would not be the appropriate procedure. If you do not mind more vermilion upper lip enlargement, then it would be a reasonable procedure to do. But it may take a concurrent lip tuck-up done from the inside the lip as well to get the desired amount of improved tooth show.
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