Q: Dr. Eppley, I have been suffering from extremely dry lips for several years. They are painful, inflamed, and become red throughout the day. My dermatologist prescribed several topical medications, but they did not work. I have consulted with him about a lip procedure called vermillionectomy using lasers that may provide the results I need to increase moisture to my lips. I have attached a picture of my lips for you to see my problem.
A: Thank you for sending your picture. In looking at it it appears the entire vermilion (red part of the lip may be involved….the picture is a little grainy) Then procedure of a vermilionectomy basically removes the dry part of the vermilion and moves out the wet part of the vermilion to the skin edges. This type of lip procedure is normally reserved for patients (usually older) in whom lip cancer involves the dry vermilion and it must be removed and reconstructed. It would work for the very dry lips because it is being replaced with vermilion which has salivary glands in it. It would make your lips, however, usually a little smaller and probably with a little less pout. (fullness) It could be regarded as an ‘extreme’ treatment for dry lips but, if the condition is severe enough, this may justify that surgical effort.
Dr. Barry Eppley
Q: Dr. Eppley, I have severely chapped lips. I have tried everything for years, been to over ten doctors, and tried every lip balm and salve that exists. It gets so chapped that it is painful and a source of constant embarrassment. I have read that chapped lips can be improved by a procedure known as a vermilionectomy. What does it look like after surgery? Will there be a bruising and will the vermillonectimes heal quickly. I have been researching the internet about the procedure. The closest thing I can find about the lip procedure is for people that have lip cancer . I don’t have lip cancer but it does give me an idea about the procedure. I have not found articles for people that severe chapped lips.
A: A vermillionectomy is used for a variety of lip procedures such as cancer excision as well as cosmetic lip reductions. It is nothing more removing a strip of vermilion with the posterior edge at the wet-dry line and the anterior edge as far forward as needed to removed the desired amount of aberrant vermilion. The excision is widest in the middle and tapers to a feather edge as it comes to the corners of the mouth. It is closed by a combination of the outer lip rolling in (vermilion) and the inner lip (mucosa) rolling out. Dissolveable sutures are used for closure. Any lip surgery does tend to swell considerably but there usually is not much if any bruising. For chapped lips, which occur exclusively on the dry vermilion, the amount of improvement obtained depends on how much of the involved vermilion lies within the excisional area.
Dr. Barry Eppley