Will Vermilion Advancements Make My Bilateral Cleft Lip Look Better?

Q: Dr. Eppley, Repaired Cleft Lip Vermilion Realignment and Insurance Inquiry Dear Dr. Eppley and Team, My name is Jessica and I am reaching out to request a consultation regarding a potential lip procedure. I am an adult with a repaired bilateral cleft lip and am currently seeking options to correct residual asymmetry and misalignment of the vermilion border. I have reviewed Dr. Eppley’s experience with lip advancement techniques, including the gull-wing approach, and I believe his expertise aligns with my needs. In my case, the concern is primarily reconstructive and stems from prior cleft surgery, rather than a purely cosmetic desire. I would appreciate the opportunity to schedule a consultation to discuss: • Whether vermilion border realignment via a gull-wing lip lift would be appropriate in my case.

A:Thank you for your inquiry and sending your picture. Amongst all cleft lip deformities the bilateral cleft is unique in that in almost all cases there is a fundamental shortness of skin between the nose in the upper lip as the pro-labial lip segment is fundamentally short/deficeint. As a result this would negate the use of any type of lip procedure whose result is dependent on skin removal such as a subnasal lip lift or vermilion advancements. While a central vermilion advancement would create more of a cupids bow shape this would also shorten the skin segment of your upper lip in an unnatural way as that skinned segment is already marginally adequate in length.

Dr. Barry Eppley

World-Renowned Plastic Surgeon