Modified upper lip lift scheduled, is 5mm removal the right amount? (Photos)

Question

Hello! I measured 16.5mm philtrum length, I want enough change to justify a scar and healing time, but I don't want too much removed where my mouth would look weird? Is 5mm a good middle of the road amount? I trust my doc but I would like a second opinion. I have surgery scheduled in January. (Yes I will dissolve all the lip filler soon, it's not attractive.)

Ruslan Zhuravsky, DO · Answer

Hi, great question. It’s hard to say how much to remove based on pictures, especially with filler. You also cannot plan a lip lift based on numbers alone. The measurements should be done with the filler dissolved as this will change the dynamics and aesthetics of the whole area. The amount removed is based on ratios, aesthetic desire, and tooth show. The amount removed may also vary between segments of the lip. I often remove more on the sides as these are diagonal and being elevated centrally. This helps recruit the outer parts of the lip and avoid relative over peaking of the middle. Once the filler is dissolved, smile and try to find a crease in the upper lip. This can sometimes give an approximate location of the extent of excision. The keys to a good lip lift are proper design, good undermining (freeing of the remaining skin), and adequate support of the deep lip structures to the immobile parts of the nasal base. Trusting you surgeon is definitely a very positive thing as well. Once the filler is dissolved, even day of surgery, remeasure the lip and elevate it to the approximate desired level to get a better sense of how much excision is required. Hope that helps!

Lexie Wang, MD · Answer

Hi sidney. The "right amount" is in the eye of the beholder. A lot of it depends on your current mouth function and its alignment to the teeth. 5mm is a decent enough removal. I would not do more than 10mm removed as it makes it much harder to close. If your philtral length is truly 16.5, you can probably handle anywhere between 4mm-6mm.

Jacob Tower, MD · Answer

Hello, hope you are well. If I were your plastic surgeon, I would dissolve the lip filler and then re-assess. We need to take into account how much dentition shows naturally, as well as the shape of the upper lip's vermilion border. I would anticipate that a relatively conservative lift of about 4-mm would be appropriate, but it's difficult to estimate from the filler distortion.
Best,Dr. Tower

Zoran Potparic, MD · Answer

I am not sure why do you need a lip lift? In your case 5 mm skin excision would be too much, based on these photos. In person, second opinion consult with a board certified plastic surgeon is recommended. Good luck.

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