Lip lift
Encyclopedia
A lip lift is a plastic surgery
procedure that corrects the cosmetic appearance of the lip
s by reshaping them to increase the prominence of the vermilion border; and to enhance the facial area above the lips into a more aesthetically pleasing shape. In corrective praxis, a lip lift procedure is distinguished from lip enhancement
, the augmentation of the lips, which can be effected with a non-surgical procedure.
There are surgical and non-surgical techniques for effecting lip lift and lip augmentation corrections to the lips. The surgical techniques include incisions below the nose
and in the periphery of the lips area of the face, the perioral area; other techniques effect the surgical incisions from inside the mouth.
Surgical aesthetics
The aesthetic ideal
of a mouth with youthful lips — shaped like a lozenge — features an upper lip with a pronounced Cupid's bow
, and much fullness to each lip; however, such an ideal physiognomy declines with age, and the lips shrink and lose anatomic definition, as the lips sag, which affects the aesthetics of the smile, by revealing less of the teeth during a relaxed smile. The American Society of Plastic Surgeons
reported 3.2 million cosmetic surgery procedures performed to mature patients, aged 55 years and older, in 2008. The patient demand for facial rejuvenation indicates that most requests do not include the mouth, which results in a surgical outcome that is aesthetically deficient.
In the 1980s, when collagen
, originally the principal filler for the lips, proved limited in effecting permanent correction, plastic surgeons then developed surgical techniques for lifting and augmenting the lips, and correcting aesthetic defects and deformities.
The “gull-wing lift” is an effective surgical technique for increasing the prominence (display) of the vermilion coloring of the lips, by removing skin
(and other tissues) as required, ether directly from or from above the white line of skin that borders onto, and sets off, the vermilion of the lips (the white roll). The incisions remove tissue and significantly alter the shape of the lips by moving up the vermillion from both peaks of the Cupid's bow outwards to the commisures, the corners of the mouth. Incisions are also made below the lower lip to increase the projection of the vermillion of the lower lip. This gull-wing lip lift usually requires an OR time of approximately 20 minutes; post-operatively, the swelling of the lips subsides at 1-2 weeks and the tightness subsides at 2-4 months. Asymmetry, under-correction, and hypertrophic scar
ring are possible complications.
Sub-nasal lip lift
A technical variant of the gull-wing lip lift is the sub-nasal lip lift (bull-horn lip lift), which involves the removal of either an ellipse or a curved-edge ellipse of of tissue from under the nose. The skin then is raised, and sutured to lift the lip and expose more of the upper-lip vermilion. Depending upon the indications of the patient, this technique can increase the drooping the corners of the mouth (commissures); thus, the sub-nasal lip lift often includes a corner-lift surgical step. In the corner lift procedure (external angle oral commisuroplasty), triangles of tissue are resected from above the commissures, thereby elvating the corners of the mouth. A descending wedge of tissue can also be removed to add contour to the Cupid's bow or to reduce bulky lips. .
Another variation of the procedure is for a surgeon to make an incision inside the mouth to loosen the mucosa and vermilion, which are then advanced and secured, leaving a portion of scar tissue inside the mouth which may take 2–4 months to heal. Yet another technique uses a "W" incision inside the mouth to create several "V" flaps, which are then used in a V-to-Y plasty technique to advance the vermilion of either or both lips. This procedure leaves no exposed areas inside the mouth, but can be painful and has a lengthy recovery period.
Thread lip lift
Another variation is the thread lift, in which a square stitch is placed from one nostril to the other and down to the peaks of the Cupid's bow. This variation has fallen out of favor because the results are short-lived.
Complications which may arise from lip lift surgery include:
In particular, the technique of removing skin at or directly above the white roll has been singled out as resulting in unfavorable scarring and stiffness in the lips.
Advancements and improvements in non-surgical fillers available for lip enhancement has reduced demand for the lip lift procedure.
Plastic surgery
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...
procedure that corrects the cosmetic appearance of the lip
Lip
Lips are a visible body part at the mouth of humans and many animals. Lips are soft, movable, and serve as the opening for food intake and in the articulation of sound and speech...
s by reshaping them to increase the prominence of the vermilion border; and to enhance the facial area above the lips into a more aesthetically pleasing shape. In corrective praxis, a lip lift procedure is distinguished from lip enhancement
Lip enhancement
Lip enhancement is a type of cosmetic surgery or non-surgical procedure that aims to improve the appearance of the lips by increasing their fullness through enlargement.-History:...
, the augmentation of the lips, which can be effected with a non-surgical procedure.
Background
TechniquesThere are surgical and non-surgical techniques for effecting lip lift and lip augmentation corrections to the lips. The surgical techniques include incisions below the nose
Nose
Anatomically, a nose is a protuberance in vertebrates that houses the nostrils, or nares, which admit and expel air for respiration in conjunction with the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes through the pharynx, shared with the...
and in the periphery of the lips area of the face, the perioral area; other techniques effect the surgical incisions from inside the mouth.
Surgical aesthetics
The aesthetic ideal
Self image
A person's self-image is the mental picture, generally of a kind that is quite resistant to change, that depicts not only details that are potentially available to objective investigation by others A person's self-image is the mental picture, generally of a kind that is quite resistant to change,...
of a mouth with youthful lips — shaped like a lozenge — features an upper lip with a pronounced Cupid's bow
Cupid's bow
Cupid's bow is a facial feature where the double curve of a human upper lip is said to resemble the bow of Cupid, the Roman god of erotic love...
, and much fullness to each lip; however, such an ideal physiognomy declines with age, and the lips shrink and lose anatomic definition, as the lips sag, which affects the aesthetics of the smile, by revealing less of the teeth during a relaxed smile. The American Society of Plastic Surgeons
American Society of Plastic Surgeons
The American Society of Plastic Surgeons is the largest plastic surgery specialty organization in the world. Founded in 1931, the society is composed of surgeons certified by the American Board of Plastic Surgery or by the Royal College of Physicians and Surgeons of Canada who perform Plastic and...
reported 3.2 million cosmetic surgery procedures performed to mature patients, aged 55 years and older, in 2008. The patient demand for facial rejuvenation indicates that most requests do not include the mouth, which results in a surgical outcome that is aesthetically deficient.
In the 1980s, when collagen
Collagen
Collagen is a group of naturally occurring proteins found in animals, especially in the flesh and connective tissues of mammals. It is the main component of connective tissue, and is the most abundant protein in mammals, making up about 25% to 35% of the whole-body protein content...
, originally the principal filler for the lips, proved limited in effecting permanent correction, plastic surgeons then developed surgical techniques for lifting and augmenting the lips, and correcting aesthetic defects and deformities.
Surgical procedures
The gull-wing lip liftThe “gull-wing lift” is an effective surgical technique for increasing the prominence (display) of the vermilion coloring of the lips, by removing skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
(and other tissues) as required, ether directly from or from above the white line of skin that borders onto, and sets off, the vermilion of the lips (the white roll). The incisions remove tissue and significantly alter the shape of the lips by moving up the vermillion from both peaks of the Cupid's bow outwards to the commisures, the corners of the mouth. Incisions are also made below the lower lip to increase the projection of the vermillion of the lower lip. This gull-wing lip lift usually requires an OR time of approximately 20 minutes; post-operatively, the swelling of the lips subsides at 1-2 weeks and the tightness subsides at 2-4 months. Asymmetry, under-correction, and hypertrophic scar
Hypertrophic scar
Hypertrophic scars are a cutaneous condition characterized by deposits of excessive amounts of collagen which gives rise to a raised scar, but not to the degree observed with keloids. Like keloids, they form most often at the sites of pimples, body piercings, cuts and burns. They often contain...
ring are possible complications.
Sub-nasal lip lift
A technical variant of the gull-wing lip lift is the sub-nasal lip lift (bull-horn lip lift), which involves the removal of either an ellipse or a curved-edge ellipse of of tissue from under the nose. The skin then is raised, and sutured to lift the lip and expose more of the upper-lip vermilion. Depending upon the indications of the patient, this technique can increase the drooping the corners of the mouth (commissures); thus, the sub-nasal lip lift often includes a corner-lift surgical step. In the corner lift procedure (external angle oral commisuroplasty), triangles of tissue are resected from above the commissures, thereby elvating the corners of the mouth. A descending wedge of tissue can also be removed to add contour to the Cupid's bow or to reduce bulky lips. .
Another variation of the procedure is for a surgeon to make an incision inside the mouth to loosen the mucosa and vermilion, which are then advanced and secured, leaving a portion of scar tissue inside the mouth which may take 2–4 months to heal. Yet another technique uses a "W" incision inside the mouth to create several "V" flaps, which are then used in a V-to-Y plasty technique to advance the vermilion of either or both lips. This procedure leaves no exposed areas inside the mouth, but can be painful and has a lengthy recovery period.
Thread lip lift
Another variation is the thread lift, in which a square stitch is placed from one nostril to the other and down to the peaks of the Cupid's bow. This variation has fallen out of favor because the results are short-lived.
Results and complications
Although surgeons report patient satisfaction with these techniques to be "high," no one variation has been sufficiently applauded to become the standard procedure. Most of these methods result in an increase in the amount of vermilion visible, but so far, quantitative data exists only for the V-Y lip augmentation, for which statistically significant increases in upper vermilion height and surface area have been measured.Complications which may arise from lip lift surgery include:
- Numbness
- Stiffness
- Pain
- Parasthesia
- Lip distortion
- Lip lengthening
- Smile deformation
- Speech impediment
- Visible scarring
In particular, the technique of removing skin at or directly above the white roll has been singled out as resulting in unfavorable scarring and stiffness in the lips.
Advancements and improvements in non-surgical fillers available for lip enhancement has reduced demand for the lip lift procedure.