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The lips serve critical life functions of eating and speaking. They serve an important social purpose and convey emotions and affection. The function and the aesthetic of the lips are closely interrelated and cannot be separated. The lips consist of the red (vermillion) portion, and the skin (cutaneous) portion.
An aesthetic lip region consists of special proportions between the relative heights of the red and skin portion of the upper and lower lips. The upper lip also forms a gentle bow with two peaks. Beautiful lips are covered by smooth and blemish-free skin and are free of wrinkles at rest and at animation. The lips are central to the image of youth, attractiveness and sensuality in women and increasingly in men as well.
Individuals with upper lip aging present with loss of the bow-like shape of the upper lip. The upper lip transforms from a three-dimensional youthful protuberance to an elongated, flattened and two-dimensional structure. There is loss of the vertical height of the upper lip vermillion and an imbalance of the height proportion between the upper and lower lips. The upper lip skin lengthens and this causes inversion of the lip vermillion and further loss of height of the latter. These changes contribute to a loss of youthful aesthetic appearance. These changes may start to manifest in individuals in their forties and are more prominent in smokers.
Elongation and thinning of the upper lip skin is due to age-related reduction of skin production of elastin and collagen fibers. The loss of upper lip fat contributes further to the skin excess resulting in lip inversion. The lip vermillion loses muscle volume and also contributes to the loss of height.
Lip lift surgery effectively reduces the elongated upper lip skin and restores the youthful proportion of the upper lip-to-lower lip height. It everts the red portion of the upper lip and increases its height. The effects are long-lasting and the scar is sited at the base of the nostrils for optimal concealment. Lip lift surgery is an ambulatory procedure performed under local anesthesia, with optional intravenous sedation if requested.
Individuals with any degree of lip lengthening and seeking long-term improvement may consider lip lift surgery.
Local anesthesia is infused into the area for optimal intra- and post- operative analgesia. The lip skin is incised and lifted off the underlying muscle. The excess orbicularis muscle may be either tucked onto itself or removed. The wound is meticulously closed to ensure optimal postoperative outcome. Lip lift surgery is a delicate art balancing sufficient excision and creating a beautiful result whilst avoiding over excision causing an over everted lip and an unaesthetic outcome.
Mild swelling is expected immediately postoperatively, which will mostly resolve by the 5th postoperative day. The stitches are removed on the 5th postoperative day and most individuals will be able to return to work then.
Postoperative swelling is reduced by remaining upright during the daytime and by elevating the head of the bed with extra pillows when asleep at night. Meticulous scar care is important in the immediate postoperative period to ensure optimal scarring and to achieve ideal postoperative results.
