Anatomical references: the upper lip (just like the lower) consists of three parts:
- dermal, found between the base of the nose and the vermilion border
- intermedial, pink in color, running from the vermilion border to the lip-seal
- mucosal, from the inner lip-seal line to the attachment to the gums
Thin lip - the intermedial part of the lip, while thick enough, lacks width. Here, there are two approaches to solving the problem, depending on length-width ratio
Problem No. 1 in the case of a thin lip: The intermedial part of the lip isn’t wide enough for the length of its dermal section (long lip). In this case, surgical methods of correction are aimed at increasing the intermedial section of the lip and reducing the height of its dermal aspect. In particular
Upper-lip lift through an incision at the base of the nose (the “Bullhorn”). Using this method, the height of the dermal section of the upper lip is reduced with the removal of a 2-4mm strip of skin at the very base of the nose. The strip being excised has three curves, making it look like the horn of a bull (hence the term “Bullhorn”). The edges of the wound are delicately stitched together with extra-fine sutures, and the stitches are removed in 1 week. In a few months, the thin post-operative scar tucked under the base of the nose becomes virtually unnoticeable.
Upper-lip lift through resection of the dermal part along the rim of the vermilion border (used extremely rarely in connection with noticeable scarring in the visible zone).
V-Y surgery on the mucosal side of the lip. This method increases both the height and the volume of the exposed vermilion section of the lip, by turning its inner (moist) surface out. That said, a number of V-shaped incisions are made in the mucosal section of the lip and then stitched together in the shape of the letter Y, resulting in the protrusion of the mucosal lip and a simultaneous increase in its volume. Resorbable sutures are used for stitching.
Problem No. 2 in the case of a thin lip: The intermedial part of the lip isn’t wide enough for the (normal, insufficient) length of its dermal section.
The V-Y surgical method is used on the mucosal side: aimed at increasing just the intermedial section of the upper lip.
Thin lip - insufficient width and thickness of the intermedial section of the upper lip. In most such cases, the preferred methods of improving the shape of the lip are:
- lipofilling (plastic surgery using the patient’s own adipose tissue)
- or the use of synthetic fillers (contouring).
In rare cases, these can be augmented by surgical corrections.
Drooping lip - long dermal section of the lip combined with normal characteristics of the patient’s own intermedial section. Corrective methods are aimed at shortening the upper lip both from the outside, as well as from the mucosal side: combination of the “Bullhorn” operation with internal resection of the mucosal section of the upper lip. - resection of the mucosal section along the entire length of the lip.
Unsatisfactory lip shape.
Depending on the problem of greatest concern, a wide array of different methods of surgical lip-lift and cosmetological correction may be used: lipofilling, bio-gels, allo- and auto-fillers, tattooing, V-Y surgery, lip-lift.
- Long (protruding) lip is frequently encountered with a congenitally-deformed chin (microgenia). Method: Resection of the mucosal section of the base of the lower lip, with or without chin-enlargement surgery by implant.
- Thin lip. Method: Lipofilling is possible in combination with widening permanent makeup.
- Narrow lip. Method: Permanent makeup.
- Wide lip. Method: Inner resection of the mucosal lip.
- The corners of the mouth most frequently have the problem of low positioning, with the formation of deep and long “marionette” lines. Many corrective methods are available for their elimination: corner surgery, lipofilling, bio-gel injections, correction of the muscle tone responsible for the drooping corners of the mouth (Botox, myotomy), face-lift.
Corner-lift or an operation to lift the corners of the lips is performed under local anesthesia and consists of the excision of small areas of skin above the corners of the lips. Unfortunately, this type of operation has not become widespread in surgical practice due to the prominence of the post-op scar.
Operation to transverse the muscle responsible for the drooping corners of the mouth (DAO resection). Two incisions, 2cm long each, are made on each side of the cheek mucous. The fibers of the muscle drooping the corners of the mouth are located and transversed. The wounds are stitched together with reabsorbing sutures. The result of the operation is a lift in the corners of the mouth, the person’s face looks friendlier. This operation is most suited to cases of highly-pronounced “marionette” lines in older patients, and may also be suggested for younger patients with a predisposition to their formation.
Rare corrective surgery for a lip-lift also includes thread suspension of the upper lip. The operation is performed through invisible micro-incisions inside the nose. Considered to be an unwieldy operation. The effect is short-lived. May be performed in patients who just want a slight increase in the height of the upper lip.