Q: Dr. Eppley, I am trying to decide between a lip lift and a lip advancement. I am aware of some of the differences between the subnasal lip lift and the vermilion lip advancement. I have read through the information concerning these two procedures on your website. As I understand it, both procedures will reduce the distance between the lower portion of the nose and the upper lip. However, the vermilion lip advancement will result in an increase in vermilion show throughout the entire upper lip, while the subnasal will only lift the central portion of the lip. In addition, the lip advancement requires an incision along the entire upper lip which will result in a scar that will most likely be longer and more noticeable than the scar underneath the nose from a bullhorn lift. I would like to know any other advantages/disadvantages concerning both procedures that I may not be aware of. Based on the photos that you have before you, I would like to know what your recommendation would be in my particular case.
A: You seem to have a good grasp on the differences between a lip lift and a lip advancement. The decision then for any patient is balancing the concern about the scar vs. the degree of improvement they desire. Unless one has an absolute pencil thin lip (in which only the vermilion advancement will be effective), many patients opt for the subnasal lip lift due to less scar concerns even though only the central part of the upper lip is affected. Doing a subnasal lip lift first does not exclude the option of proceeding later to a vermilion advancement if one finds they want a more significant result.
Dr. Barry Eppley