Dr Lisa Friederich 1300 375 472
A Lip Lift is a surgical procedure to shorten the length of the skin of the upper lip (the ‘cutaneous lip’), that portion between the base of the nose and the upper edge of the red lip (the ‘vermillion’).
An incision is made in the crease under the nose and a lower parallel incision is made below this to excise a predetermined amount of skin. The shape of this is often termed a ‘Bullhorn’ excision as it is curved in the same shape as a bull’s horns.
The muscle underneath is left intact. The lower skin incision is sutured the the top incision using deep absorbable sutures and fine outside sutures. Sometimes Botulinum toxin is injected across the top lip to decrease the downward pull of the muscle in the upper lip and improve wound healing.
Shortening the skin of the lip in this manner elevates and rotates the vermillion of the lip, thus enhancing the aesthetics of the lower third of the face.
The ideal aesthetic proportions of the face divide it horizontally into thirds, the upper third is from the hairline to the glabella or mid brow level, the middle third is from here to the base of the nose, and the lower third is from here to the chin. Within these areas we can apply the Golden ratio of Phi which is 1:1.61, or roughly 1//3 : 2/3.
Applying this to the lower third of the face, the upper third is from the base of the nose to the mouth opening, and the lower two thirds are from the mouth opening to the chin. It isn’t possible to change the position of the mouth opening, but by altering the upper cutaneous portion of the lip, the size of the red lip and the chin the aesthetics of the lower face can be enhanced.
Some people are born with long upper lips, some develop long lips with aging changes. As the lip loses volume and support, it flattens out and unfurls so increasing in length- a lip lift is a very good operation to restore this balance.
The ideal candidate is someone who has a wide enough nose in relation to the width of their mouth as the scar is limited in horizontal dimension by the nasal base- if you have a narrow nose and a wide mouth, you will get lift primarily in the central portion of the lip and it may not exaggerate a downward turn to the corner of the mouth. A separate corner of mouth lift can be performed, or the lip-lift scar can be modified slightly to pull up more lateral skin. It is something that needs to be assessed on an individual basis.
The biggest concern for patients (and surgeon!) is the visibility of the scar. All scars take time to form and then go through a process of remodelling in which they fade and contract. Delicate tissue handling and suturing techniques contribute to forming the best scar possible. The use of Botulinum toxin A has also been useful in decreasing tension across the scar in the healing period. Aftercare is also important, limiting excessive oral movements, such as laughing or eating large food portions are not advised in the early postoperative period. Scar massage, silicone gel or tape can also aid in scar maturation. Laser can also be used for persistent red scars.
The procedure can be performed in a hospital under general anaesthetic, or in the office under local anaesthetic.
Please let us know if you would like further information or to book a consultation. You are welcome to send photographs to Dr Lisa to see if you are a suitable candidate. All such images are treated confidentially.