What Are The Details Of Doing A Subnasal Lip Lift?

Q: Dr. Eppley, I am interested in a subnasal lip lift. When you perform them, how is the healing of the scar? I know the scar is placed at the base of the nose, but I have seen some horror stories where the incision is just below the nose and thus is very visible. Do you also pull the muscle or just the skin with the lip lift? I have a 21mm gap between the base of my nose and my upper lip. After my rhinoplasty (which I am having first) I am presuming this gap will stretch to approximately 23mm- in any case I am hoping to have a 15mm gap.

A: The key to a good subnasal lip lift scar is two-fold; place it exactly in the nasal-lip crease and it should follow the shape of the nasal base (wavy) and not a straight line. You never manipulate the orbicularis muscle in a subnasal lip lift, that is an assured way of causing tightness and smiling animation deformities. With a 21 to 23mm lip to nose distance and using a 1/3 distance reduction (amount of skin excised), you should be reduced to a 15mm vertical length.