Can lip incompetence from a lip lift be fixed? Would a corner lip lift help? (Photos)

Question

I'm 7 months PO from a lip lift that has caused me to have a constant open mouth with a bugs bunny look. I am able to make my lips meet if I consciously push them together but in my normal relaxed state my mouth appears open with only my two front teeth showing. Its as if my lip goes out and not down. I also had a DPFL at the same time which caused nerve damage causing me not to be able to smile, this has mostly resolved itself. My surgeon has suggested a corner lip lift so that it doesn't look so bad but I'm reluctant to have even more lip taken away. Is there anything else that can be done to fix this? I have had 2ml of botox put into the two muscles that run down from my nose and this has helped a small amount.

Gary M. Horndeski, MD · Answer

You would benefit from an eccentric lip lift.  This does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.  However, in your case, I would not take anything centrally between your nose and upper lip.  This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.

Jeffrey H. Spiegel, MD · Answer

The lip lift was perhaps a bit aggressive in the center. but you need volume in your lips. Fat, filler, or tissue can be added to recreate the missing volume and give you a more natural and even attractive result.

Anna Chacon, MD, FAAD · Answer

Thank you for your detailed question and for sharing your experience. Lip incompetence following a lip lift, especially when it creates an unnatural "open mouth" appearance or excessive central tooth show, can be very distressing—and unfortunately, it's not an uncommon complication when tissue is over-resected or when lip dynamics are altered post-surgery.

What Might Be Happening:
Over-resection of central upper lip tissue can shorten the vertical length excessively, pulling the upper lip upward and outward, giving the appearance of protruding teeth ("Bugs Bunny" look).

Muscle imbalance or changes in tension—particularly when combined with a deep plane face-lift (DPFL)—can temporarily or permanently alter how your lips rest and move.

Post-surgical scarring and tissue stiffness may also contribute to unnatural positioning and limited relaxation of the lips.

Can It Be Corrected?
Yes, but the approach depends on the degree of tissue loss, scarring, and functional impairment.

1. Corner Lip Lift
Your surgeon’s suggestion of a corner lip lift is intended to rebalance the lip shape by lifting the lateral aspects, which may help camouflage central protrusion and restore more symmetry. However, as you rightly noted, further excision of tissue—particularly when central over-resection is already an issue—must be approached cautiously.

2. Lip Reversal or V-Y Mucosal Advancement
In cases of over-resection or upper lip eversion, mucosal advancement procedures (like a V-Y advancement) can restore internal volume and reposition the vermillion. This helps roll the lip back downward and inward, creating better coverage of the upper teeth at rest.

3. Filler Correction
Hyaluronic acid fillers can sometimes restore balance subtly by adding volume to the lip body or corners, though they are not a permanent fix and won't correct true lip incompetence if tissue removal was excessive.

4. Fat Grafting
For more long-term volume restoration or softening of scarred/stiffened areas, autologous fat grafting may help improve lip contour and mobility.

5. Neuromodulators (Botox)
It’s good that you’ve tried Botox to modulate the muscle activity—it may continue to be helpful if certain muscles are contributing to the unnatural lip position. However, it's often a temporary and partial solution.

Considerations Before Any Further Surgery:
A thorough functional and aesthetic assessment is critical before proceeding with additional excisions like a corner lift.

Scar maturity improves over time—so waiting a full 12 months post-op may give you a better baseline for revision planning.

Choose a provider highly experienced in lip revision procedures, as these are far more complex than initial surgeries and require precise balance between form and function.

Final Thoughts:
Your concerns are absolutely valid. While the situation may feel discouraging, there are corrective options that can restore both appearance and comfort over time. The key is a careful, measured approach that prioritizes restoring function without sacrificing additional tissue unnecessarily.

Tim Neavin, MD · Answer

A corner of mouth lip may improve the appearance, but I would consider fat transfer to the lips to plump them up.  A COML will leave a scar just at the border of the lip.  That would be my last resort.

Can lip incompetence from a lip lift be fixed? Would a corner lip lift help? (Photos)

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Answer: Lip Lift

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Can lip incompetence from a lip lift be fixed? Would a corner lip lift help? (Photos)

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Answer: Lip Lift

Answer: Lip Lift

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Everything you need to know about Lip Lift

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