Will A Subnasal Excision Get Rid Of My Horizontal Upper Lip Line?

Q: Dr. Eppley, These are the two procedures I was hoping to discuss: 

1) Buccal fat pad removal with perioral liposuction to get a more defined jaw line and decrease my chubby cheeks. I’ve had chubby cheeks my entire life and I was hoping as I got older they’d get smaller. They have a bit – but not to the extent that everyone was telling me they would. At complete rest it doesn’t look as chubby anymore but the moment I smile even a little or talk – they return. 

I’m not worried about the potential effects of buccal lipectomy that can happen when 20-25 years down the line. I feel like when I’m 60 I’ll address the issue then and I’d rather not be so self conscious and have the jaw line I want now rather than worrying about what’s gonna happen when I’m 60. 

I’ve attached pics below showing me at rest and laughing. 

2) Upper lip lift. I don’t want the size of my lips to change because I do think they’re proportional to my face. But, I’m to achieve two things: 

1) to show more of my upper teeth (I think this will also ensure I don’t smile “so big” therefore reducing the chubby cheek effect when I’m laughing 🙂 

2) since birth I’ve had an extra layer of skin located under my nose (I’ve attached a pic below). At rest it’s not overly noticeable, when I talk, you can somewhat see it. The pic I’ve attached is me prominently protruding it. As a child a surgeon suggested I have it removed but my parents were worried it would leave a mark/scar and that’s really been the only thing that’s stopped me from getting it taken off. I happen to come across your work on a message board and would like to discuss whether he thinks a bullhorn lip lift would ensure that this layer of skin is taken off. 

Thanks so much, 

A: Thank you for your inquiry to which I can say the following: 

1) The buccal lipectomy/perioral liposuction procedure is straightforward so I don’t have any new insights into them.

2) By definition it is not possible to do a subnasal lip lift and not change the size of the upper lip…unless that subnasal lip lift is 3mms or less. If one only wants to show more upper teeth a smile line reduction (mucosal excision along the lower border of the lip) is the procedure to do so. This will, however, make the upper lip look a bit smaller.

3) If there is a roll of extra skin right under the nose of the upper lip, a subnasal excision would be effective. I did not see an attached picture showing this roll so I don’t know exactly where it is or how big it is.

4) The combination of a subnasal excision and a smile line reduction would cancel each other out in terms of lip size….but would improve tooth show and reduce/eliminate the subnasal roll.

Dr. Barry Eppley

Indianapolis, Indiana