What can be done to enlarge or elongate the middle portion of my lip so that function is regained? (photos)

Don't know how far you are out from surgery. The lip retraction and lack of function may improve over time. And based on your line of questioning, you may also be referring to lip incompetence / inability of the lips to close properly at rest. Scar injections may help some of your issues. Postoperative follow-up is very important.

Thank you for sharing your concern — I understand how distressing this situation must be. When too much skin is resected during a lip lift or when the procedure affects the balance and structure of the lips, it can lead to both functional and aesthetic complications, such as compromised oral competence, chronic dry mouth, and distortion of the natural lip angle.

To address these issues, several potential strategies may be considered:

Lip Augmentation with Structural Filler or Fat Grafting: This can help restore volume to the central portion of the lip and potentially improve lip seal and projection. Fat grafting, in particular, may offer a more durable and natural correction.

Mucosal Advancement Flap: This surgical option involves advancing inner lip tissue outward to increase vertical height and improve function. It’s particularly useful when there is a shortage of external skin.

V–Y Mucosal Advancement: A technique often used in lip reconstruction that helps lengthen and increase central lip bulk, potentially improving both appearance and function.

Corrective Surgery or Revision Lip Lift: In certain cases, carefully performed revisions can address asymmetry or over-resection by adjusting angles or redistributing tension, but this must be done conservatively.

Neuromuscular Retraining Therapy: In cases where function is impaired due to changes in tension or muscular adaptation, therapy focused on retraining lip movement may be beneficial.

Improving oral seal and reducing lip eversion is key to addressing the dry mouth. A combination of structural support and, when appropriate, minor surgical adjustments often leads to the most satisfying results.

While this is a complex and delicate area, there are viable options that can help restore both function and appearance.