F/55 & always had downturned lips, am I a candidate for a corner lip lift? (Photo)

Question

F/55. I've always had downturned lips, but as I've aged they've gotten worse. People ask what's wrong when my face is resting. I'm interested in a corner lip lift. I met with a plastic surgeon the other day, and he said that because my oral commissures are so long, the scars will be too prominent. I'm meeting with another surgeon in a few weeks for a second opinion. In the meantime, I'd love to hear a few other opinions. Thanks in advance.

Arif Eroglu, MD · Answer

Hello; The sagging of the lip corners; the loosening of the cheeks, the loosening of the suspensory ligaments on the face, the decrease of the fat tissue; that provides support to the cheeks and the strengthening of the depressor muscles. Corner Lip Lift treatment can be done alone; but, if the other existing problems are not solved, the affect will not be long. Therefore, I recommend for that; it would be done together with Endoscopic Facelift or Deep Plane Facelift application for your cheeks.

Manish H. Shah, MD, FACS · Answer

Hello El Bee,
Thanks for your question. You may need to perform both a subnasal lip lift and a medializing corner mouth lift to get an aestheticially balanced outcome. Some might even recommend a deep plane facelift to manage lateral face descent that can worsen corner mouth descent. Speak with your surgeon about these issues if you can.
Good luck,
Dr. Shah

Farhad Rafizadeh, MD · Answer

A corner lip is definitely helpful in your case. The scar will be at the junction of the vermillion and skin but it has to be extended lateral to the corners of your mouth and that extension could be visible. One has to make sure you are an excellent healer before doing this procedure.

Lexie Wang, MD · Answer

I agree that the corner lip lift is not going to br your friend here, esp because your red lower lip also does not extend that far -- it'll end up looking like you have more lip on top than on the bottom if you do that. I would work on doing neurotoxin to the DAO and platysma to prevent the downturned pull of that muscle and then you may also need to think about a lift type procedure.

Gary M. Horndeski, MD · Answer

I recommend a lip lift. A lip lift 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. This technique will take most skin laterally to pull up the corners. I would not recommend external incision where the incision is made at the lip line. This can leave an unattractive scar.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Anna Chacon, MD, FAAD · Answer

A corner lip lift can be an effective procedure for addressing downturned lips and improving facial aesthetics, particularly for individuals who feel that their facial expression appears sad or upset at rest. However, the success and appropriateness of the procedure can depend on several factors, including the anatomy of your lips, the elasticity of your skin, and the skill of the surgeon.

Given that you have always had downturned lips and they have worsened with age, it is understandable that you are seeking a solution. Here are a few considerations based on your situation:

1. **Anatomy and Skin Condition**: If your oral commissures (the corners of your mouth) are particularly long, as the first surgeon mentioned, it could indeed make the scars from a corner lip lift more noticeable. The length and elasticity of the skin around your mouth can affect how well the scars heal and how visible they are post-surgery.

2. **Alternative Procedures**: There are other procedures that might help achieve a similar outcome with potentially less noticeable scarring. These include:
   - **Filler Injections**: Dermal fillers can sometimes be used to lift the corners of the mouth. This is a non-surgical option that can provide temporary improvement.
   - **Botox**: Botox injections can sometimes relax the muscles that pull the corners of the mouth downward, although this is also a temporary solution.
   - **Other Surgical Techniques**: There might be other surgical methods to address downturned lips that are more suited to your anatomy, such as a more tailored approach to the corner lip lift or combining it with other facial rejuvenation procedures.

3. **Second Opinion**: It is wise that you are seeking a second opinion. Different surgeons have different techniques and experience, and another surgeon might have a different approach or opinion about the visibility of scars. Make sure to discuss your concerns about scarring and ask to see before-and-after photos of patients with similar features who have undergone the procedure.

4. **Realistic Expectations**: Ensure that you have a realistic understanding of what the procedure can achieve and the potential for scarring. Ask the surgeon to explain the typical healing process and what you can do to minimize scar visibility, such as post-operative care and potential treatments for scar reduction.

5. **Consultation Questions**: When you meet with the next surgeon, consider asking the following questions:
   - How many corner lip lifts have you performed, and what has been your experience with patients who have long oral commissures?
   - Can you show me before-and-after photos of patients with similar anatomy?
   - What are the potential risks and complications, and how can they be minimized?
   - What are my other options if a corner lip lift is not suitable for me?

Ultimately, the decision should be based on a thorough understanding of the potential outcomes, risks, and benefits as explained by a qualified and experienced plastic surgeon. Continue to gather information and weigh your options carefully before deciding on the procedure.

Berat Cigdem, MD - Account Suspended · Answer

For addressing downturned lips, combining DAO (depressor anguli oris) Botox and a Facelift can be an effective solution. 
DAO Botox relaxes the muscles pulling the mouth corners down, giving an uplifted appearance. 
A facelift further enhances this by lifting sagging facial tissues and improving overall facial harmony. 
Together, these treatments provide a comprehensive and lasting improvement.

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