Will A Vermilion Advancement Improve My Upper Lip Asymmetry?
Q: Dr. Eppley, I am looking for improved upper lip symmetry. I would like to show my upper teeth more when I smile. As of right now my left side is droopier than the right. As well as when I smile, I would like my teeth to be exposed more.
I wasn’t born like this. Never had trauma. Started to notice this 3-4 years ago, when I started to use Juvederm fillers (root cause of the problem?). No fillers for the past 2 years. I even did a reversal around 9 month ago to make sure there is no residue. Never had botox in the area.
Considering direct lip lift (maybe in conjunction with bull horn) but tissue needs to be lifted laterally vs in the middle. NOT looking for Botox or fillers.
Most in surgeons here are not trained to perform modified or direct lip lift and are concerned about scarring along vermilion border. They suggest bullhorn lift, but that alone will only exacerbate the problem. As a young caucasian female, I noticed scars heal well on me, almost unnoticeable.
A: Thank you for your inquiry and sending your illustrated pictures. For cases of lip asymmetry where the vermilion borders are at different vertical levels, only a vermilion advancement (wha you are calling a direct lip lift) will be effective. By directing relocating the vermilion-cutaneous border on the left side can you have sustained improved lip asymmetry. You are correction in that fillers and a bullhorn lip lift will not effective as the pull of a subnasal lip lift is central and not lateral. And while this does result in a fine line scar at the vermilion border it does heal in most cases fairly well and is an acceptable tradeoff for the improved lip symmetry.
You may be correct in that the cause may be well be the use of injectable fillers since your lip asymmetry did not exist before their use and there really is no other case for it without a traumatic injury history.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.