Lower lip issue - what can be done to resolve this? (Photo)

Thank you for your question and for sharing your concern — I understand how frustrating it can be when the aesthetic result doesn’t match your expectations, especially after a surgical procedure like a lip lift.

If your upper lip appears to hang down or look unnatural when you smile, it may be due to changes in lip dynamics or muscle function that occurred after your lip lift. While a lip lift primarily focuses on shortening the distance between the upper lip and the base of the nose, it can sometimes alter the natural movement or resting position of the upper lip, which in turn can affect the overall harmony between the upper and lower lips.

Here are a few potential options to explore:

Neuromodulators (e.g., Botox): Small amounts strategically placed can soften overactive upper lip muscles (like the levator labii superioris), which may be contributing to the downward pull during your smile.

Dermal Fillers: Hyaluronic acid-based fillers can sometimes help rebalance the proportions and volume between the upper and lower lips to restore symmetry.

Revisional Lip Lift or Surgical Correction: If the result is due to excessive lifting or poor healing, a consultation with a facial plastic surgeon or cosmetic dermatologist can help determine if a revision procedure is appropriate.

Laser Resurfacing or Microneedling: If scarring or tissue laxity is contributing to the shape, these treatments may help improve skin texture and tone around the lips.

Your lip lift did not properly address your Aesthetic issues. Here are the problems:
1) Your upper lip skin (philtrum) is still too long.
2) The ratio between the distance between the nose to the lip border to the ratio between the lower lip border to the chin is more than 1/2 and it should be closer to 1/3.
3) You have too much lip filler in your lips that is distorting your lips and causing the upper lip to bulge when you smile.
Treatment:
1) Be a lot more selective about where you get your filler injections. Have the excess filler dissolved.
2) Your lip lift needs to be done again to address the Aesthetic issues, make the upper lip shorter to bring it into a better ratio, and hopefully show some upper teeth.

Although you have had a previous lip lift, you may benefit from a repeat lip lift. You do not have any incisor show in repose. 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.

Best Wishes,

Gary Horndeski, M.D.