In today’s fast paced field of cosmetic facial surgery lip enhancement is one of the hottest and most requested options. The most common lip augmentation procedures include injectable fillers, lip implants and unknown to many patients, subcutaneous lip lift. This procedure is also called “subnasal lip lift”.
What is a “Lip Lift”?
A subcutaneous lip lift is a procedure where excess skin and muscle are removed from the upper lip, just under the nose. This procedure is done for two reasons; first to shorten the aging lip and secondly to roll out the upper lip to provide pout.
Young patients have shorter, fuller and more pouty lips and as we age, the lip elongates and loses volume and pout. In addition, upper lip excess can cover the front teeth in some patients giving them a “denture smile” where the teeth are hidden while speaking and smiling. A surgically shortened lip can provide a more youthful and cosmetic show of teeth.
Who is a candidate for Lip Lift?
This procedure is most commonly performed on patients with an excessively long upper lip from heredity or aging. The lip must be at least 18 mm long from the bottom of the nose for the patient to be a candidate for this procedure. Most patients requesting lip lift are those who are aging and losing normal lip form and function, younger patients with long lips or any patient who has lack of normal incisor (upper teeth) show when smiling or speaking.
How is the procedure performed?
This procedure is about 30 minutes long and can easily be performed with local anesthesia or IV sedation if the patient wishes. The lip is measured and marked and a “mustache” or Bull Horn” configuration of excess tissue is removed. The can include skin or skin an muscle. The incision is closed with very fine sutures and the patient is asked to refrain from excessive oral function for several days.
This must be done in a very precise and controlled way or the procedure will not be effective and the scar will be noticeable. When performed correctly with normal healing, the procedure heals in about 7-10 days and by 30 days the scar is usually hardly perceptible. If the scar is visible it can easily be lasered to hide it.
The image to the right shows the area of skin to be excised in yellow and the right image shows a typical lip lift scar 3 weeks after the procedure.
Predicting the Result
While it is impossible to give a patient and exact prediction of the anticipated result, on thing that may be accurate in some patients is positional prediction. In some patients, reclining, holding their chin up and looking in a mirror will allow gravity to raise the lip and expose some of the upper front teeth. I have found this to be an accurate prediction in some patients.
The left picture above shows the position to decrease the gravity on the facial tissues. The picture on the above right is take with the patient sitting upright and with the patient lying down. Not the increase tooth show when the patient is lying down, thus simulating a lip lift.
The picture below shows a patient before subnasal lip lift on the left. The middle picture shows that the lip is shortened and rotated outward for increased protrusion. The right image shows same patient after the subnasal lip lift.
The patient shown below had a lip lift and the yellow arrows show the relative shortening of the upper lip. The patient also shows more teeth at rest and with smile, which makes a younger looking patient. Older patients may not show any or little upper teeth which is sometimes called a “denture smile”. The lip lift shortens the upper lip and allows the upper teeth to be more visible at rest and when smiling.
This image shows a patient with an elongated upper lip of 22 millimeters in the left picture. The right picture shows the 8 mm excess of skin that will be removed to shorten the lip, produce more tooth exposure and provide some pout and form to the upper lip.
The image below shows a patient before and after subcutaneous lip lift by Dr. Niamtu. Note the shortened lip with improve pout as well as the increased amount of upper tooth show consistent with a more youthful lip.
The patient below is shown before and after lip lift surgery to shorten the upper lip and show more teeth at rest and smiling.
The patient below show before and after pictures from lip lift by Dr. Niamtu. Note the shorter lip and more aesthetic exposure of teeth when smiling and with the lip at rest.