What Is The Difference Between A Commissurotomy, Commissuroplasty And A Mouth Widening Procedure?

Q: Dr. Eppley, I am interested in a mouth widening surgery since I have a quite small mouth, that is not very aesthetically pleasing or pretty. Due to the golden ratio: A ratio of lower lip vertical width to upper lip vertical width of 1.6 is also ideal. Now the optimal horizontal width of your entire relaxed mouth (what it looks like when it’s closed with no voluntary effort to widen it) to nose ratio approaching 1.62:1 has been recognized as a very important contributing factor as well in overall perception of facial beauty – the attractive mouth to nose ratio of 1.5:1 should be revised to 1.618:1. 

Therefore I did some research on what could be done and I read that there are: surgical methods developed for treating microstomia (a mouth opening that is abnormally small). This procedure is traditionally used for correcting congenital microstomia, or acquired microstomia through burns or disease. However, certain plastic surgeons are well-trained in adapting these surgical techniques for widening healthy narrow mouths using a procedure called a commissurotomy, followed by a commissuroplasty. The first procedure is the cutting procedure and the second is to establish new lateral commissures and rearrange the muscles on the enlarged mouth so scarring is minimal and the mouth remains fully functional.

The photos i want to attach are both pictures of the actress Freida Pinto whose smile I want – and that includes the way her mouth looks when she laughs -, and one of the reasons that is, is because I think her smile/mouth is a bit similar to mine in the way it looks and “functions” (if you can say that). But I will also attach photos of the mouth widening procedure in drawings an such I have found on the internet.

A: Whether you call it a commissurotomy, commissuroplasty or mouth widening procedure these are all basically the same operation. Skin has to be removed, some muscle resected to prevent relapse and allow a pathway for the vermilion-based mouth corner to move into on its way to the outer margin of the resected skin to establish the widened mouth corner. 

I would refer you to one of my websites, www.exploreplasticsurgery.com and put in the term Mouth Widening in teh search box. There you will find multiple articles I have written on his aesthetic perioral topic.

No matter how the procedure is done it all comes down to how well the mouth corner scars heal and appear and the acceptance that there is a relatively high risk of scar revision needed for them.

Dr. Barry Eppley

Indianapolis, Indiana