Lip Reduction
Although many people seek lip augmentation, lip reduction is also a surgical option. This procedure is performed under local or IV anesthesia and takes about 30 minutes per lip. The recovery is approximately one week, depending on the degree of swelling. The following pictures show reduction of the upper and lower lips and treatment for other issues.
Dr. Niamtu recently had the honor of publishing a textbook chapter in Facial Plastic Surgery Clinics of North America on Lip Reduction.
Niamtu, J
Lip reduction surgery (reduction cheiloplasty).
Facial Plast Surg Clin North Am. 2010 Feb;18(1):79-97.
Who is a candidate for lip reduction?
lip reduction is performed for several reasons. Most commonly, patients have lips that are too big and want them smaller as shown below.
This image show a typical patient presentation for a patient desiring lip reduction
In addition, some patients have situations, especially in the upper lip that causes hanging excess skin which is bothersome.
This patient above shows a typical presentation of a patient with excess upper lip tissue. The patient is shown at rest and smiling.
Other reasons for lip reduction include post trauma cases with scarring or asymmetry and congenital defects.
Most patients with large lips do not show an excessive amount of tooth structure, but patients with a "buck" tooth appearance or those patients that show excessive tooth structure at rest or when smiling may not be reduction candidates. The reason for this is that when reducing the lips in this type of patient, more tooth structure may be visible and have a negative aesthetic outcome.
Can the chin affect the size of the lips?
In many cases (especially in African American patients) a recessive chin profile exists. Without the normal chin support, the lower lip can look even bigger that it is and can droop. By performing simultaneous lip reduction with chin implant placement, two small procedures add up to a remarkable post operative result. The picture below shows a before and after image of a patient that underwent both lip reduction and chin implant placement.
This patient underwent minor lip reduction with simultaneous chin implant surgery
How is lip reduction performed?
Lip reduction is generally performed with IV sedation and takes 20-40 minutes per lip depending on the complexity of the procedure. Dr. Niamtu evaluates the patient when they are at rest, smiling and speaking and then determines the amount of tissue to be reduced.
The above image shows the excess skin being marked before the reduction surgery. In this case, the outlined crescents of tissue will be removed to decrease the size of the lip.
What is the recovery?
The average recovery is about 7-10 days. For patients that do not swell excessively this is accurate, however, occasionally, patients can swell excessively and will require a longer recovery. The suture line may look irregular at first but the result settles in and continues to improve over 6-12 weeks. In rare cases, a touch may be necessary.
What does the scar look like?
The surgery is perfromed to make the scar on the inside of the mouth. The scar may feel thick for several weeks, but generally heals to a point that it is almost invisible. The patient below shows a lip reduction scar on his lower lip 6 weeks after surgery.
Case presentations
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The above patient was treated with upper and lower lip reduction
The patient above was treated for unsightly excess upper lip tissue.
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The above patient was treated with upper lip reduction ONLY to decrease the size of the upper lip.
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Upper and Lower Lip Reduction
Lip Reduction after Overdone Fat Injection
The patient below was involved in a motor vehicle accident and had fat injection to build up her lip. Unfortunately, too much fat was placed in the lip and the patient required lip feduction to remove the excess fat and lip tissue.
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In addition to cosmetic lip reduction, some patients require lip reduction from trauma. It is not uncommon for an injured lip to heal with lumps or bumps that can look unattractive and impair function. Dr. Niamtu can reduce these traumatic scars (hyperplasia) to form a more normal lip.
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The above patient sustained a laceration to his right lip which healed with a large lumpy scar. Dr. Niamtu removed the scar to normalize the appearance of the lip.
Lip Reduction for Lip Biting Patient
Some patients bite their lips as a nervous habit and can develop significant scar tissue that makes the lip larger and unsightly. The case below shows one of Dr. Niamtu's lip reduction patients. The picture shows the patient before, the area excised and the after image.
Cosmetic Lip Lift
Shortening the upper lip can ehnance lip and face aesthetics. It allows long lips to be shortened, allows more exposure of the front teeth and produces an attractive pout and fullness.
click here for more information about Dr. Niamtu's lip lift procedure.