Lip Enhancement

3 month post op views of permanent upper and lower lip enlargement using the the technique of vermilion gullwing lip advancement. Notice no visible scars on either upper or lower lip. The asymmetric shape of both upper and lower lips preop was corrected with a more pleasing balanced shape Also reducing the distance between the upper lip and nose is more youthful. Fillers can even be added later for further enlargement

1 month followup upper and lower lip vermillion gullwing lip lift . Closeup shows the well healing scars and any remaining redness from suture marks will disappear shortly . This is long lasting and all done without fillers or implants. Fillers, though, can be added at a later date for further enhancement and volume.

Three week postoperative view of a young lady who underwent multiple procedures including reconstructive rhinoplasty, septoplasty and adenoidectomy and turbinectomy to improve her breathing, upper lip vermilion border lip lift, chin implant and neck liposuction and submental neck tuck. As can be seen in the preoperative pictures, the patient presented with a markedly deviated nose to the right probably secondary to a prior fracture with a small bony hump and spicules. She also had a depression in the mid vault of her nose on the left side with narrowing of her mid vault region as seen on the three-quarter view. She also had a small upper red mucosa of her lip, elongated white upper lip region between the red lip and the base of her nose. She also had somewhat of a mildly recessed chin and submental neck fat hypertrophy. It was felt that her neck was not only in the subcutaneous compartment but also in the deeper facial planes of the submental area underneath the platysma. For this reason it was felt that both liposuction of the neck and a submental neck tuck with deep fat correction and platysma muscle suturing was necessary. Her rhinoplasty involved correcting a small bony hump and placing a cartilaginous graft over her left mid vault depression. The lip advancement was done by excising 4.5 mm of upper lip skin to make her upper lip more in proportion with her lower lip and the rest of her face. A nice Cupid’s bow was also developed. A small extended prejowl implant was placed through the submental incision and the submental neck tuck as previously described was done. As can be seen in the postoperative pictures, she now has a more pleasing appearance to both her profile and frontal views of her face. Her chin, neck, upper lip and nose have more pleasing contours now and in balance with all three zones of her face. In addition, her breathing is significantly improved after correcting the deviated septum and performing the inferior turbinectomy and adenoidectomy. Her appearance will continue to improve as she is only at a three weeks postop.

63-year-old lady who underwent a moderately extensive rejuvenation process for her face and neck. As can be seen in the preoperative pictures, the patient was suffering from significant brow ptosis, periorbital wrinkles, underdevelopment and atrophy of her upper and lower lips and face and neck skin laxity. The patient underwent a coronal browlift to tighten her forehead and correct her sagging brows. The facelift included a skin and SMAS dissection and platysmal tightening of her neck. As can be seen on the lateral postop pictures, her excess jowl, neck and midface skin are now repositioned to a more youthful appearance. In addition, upper and lower lip advancement was done to enhance the shape and volume of her lips. It shortens the distance of skin between her nose and upper lip.

This is a relatively early three month postoperative picture and although the incision lines are barely noticeable, they will continue to improve with time. Finally, corner of the lip lifts were done to help improve the downturned outer edges of her lip. Her lips could not have been enhanced by any other procedure except for this skin cutting lip lift advancement. Purely utilizing a volume or graft injection to her lips would not have been beneficial since the patient had virtually no red lip show to begin with. It is still obvious on the patient of the somewhat aging appearance of her skin, especially in the perioral/upper and lower lip area where she has deep vertical creases. Facelifting cannot improve this. These areas will be approached with a chemical or laser peel at a later date. However, this cannot be safely done until six months of healing has occurred from the time of the facelifting procedure.

Post-operative views of a young lady who underwent upper lip only lip augmentation with the Advanta PTFE (Gortex oval lip implant). This is an improved but reversible implant that nicely contours the lip. The patient notices no distortion and no foreign body feeling in her lip with normal sensation and normal mobility of her lip. Notice the increased fullness of her upper lip secondary to the implant. Also notice on the lateral view her underbite/recessed upper lip deformity is now corrected secondary to the augmentation with the Advanta lip implant.

Long-term six year post-operative result of a patient who underwent improved enlargement of her upper and lower lips utilizing the Vermilion Advancement Technique with skin excision only and no implant or injection. The patient also underwent upper and lower lid blepharoplasty. As can be seen in the post-operative pictures, her lips appear quite natural and more voluptuous and have maintained their added height and fullness. The patient also claims the lips feel quite natural and denies any numbness or tightness.

Improved upper and lower lip enlargement obtained with AvantaTM PTFE Super Soft natural feel implants.

Young patient who underwent multiple procedures to improve the appearance of his smile, lips and recessed chin. Surgery allowed for correction in the amount of gum show with a lowering of the upper lip. Correction in size of both upper and lower lips. Chin implant also placed for better profile.

Two month postoperative result that demonstrates the remarkable transformation that can occur in a highly motivated individual who undergoes a combination of successful plastic surgical procedures and follows a strictly regimented diet and exercise program. Surgically, the patient underwent a reconstructive rhinoplasty utilizing the open approach so that her asymmetric drooping tip could be lifted in a more prominent, symmetric, and aesthetically pleasing position. As noted in the preoperative pictures, her nostril openings were absent from the frontal view whereas now some visualization of the nostrils, which is desired, can be seen. In addition, her flaring nostrils, especially on the left side, were corrected with a Weir excision. The twisted C-shaped deformity of her nose is now straight in the midline. On her profile, however, we can see that there is too much nostril/columella show preoperatively and this was decreased to compliment her now more defined, stronger tip that stands apart from a lowered, more streamlined dorsum as some bony cartilaginous hump was corrected. In addition, meticulously performed neck and jaw liposuction/sculpture was done in order to refine her neck. This was all achieved through a quarter inch incision placed in her submental, under the chin, skin crease. No facelifting or other invasive type procedure was necessary as her skin retracted quite well to her underlying bone structure. Good results for this portion of her surgery was already being seen after a weekend length of time. Losing weight in the postoperative period also positively impacted her final results and is obviously partially responsible for her final outcome and its importance should not be ignored. During the same procedure, the patient also had radio surgical ablation to correct small vessels of her cheeks and to correct small protruding lesions on her chin and other areas of her face. As can be seen in her postoperative pictures, the tone of her skin is more even and healthier appearing. The patient also underwent a small amount of Juvoderm injection to her to add some more pout and bulk to her upper and lower lips. Finally, some neurotoxin was injected in the glabella and forehead regions to further smooth her forehead and to allow for some eyebrow elevation which is especially noted on her three-quarter view. The patient’s breathing was significantly improved by simultaneously performing a septoplasty and turbinectomy during the rhinoplasty procedure.