The middle of my upper lip hangs down when smiling and covers my teeth. Anything that can be done to create symmetry? (photo)

Question

Whenever I smile or laugh, the medial portion of the upper lip seems to hang down very low often covering the front two teeth. Is there anything that can be done to create more symmetry in the lip. I hate how it always looks like I don’t have front two teeth. My nose also often has an excessive flaring (v-shape) when smiling if that helps. My resting face is looks natural and normal. It’s only me smile that causes a problem.

Steve Laverson, MD, FACS · Answer

In disagreement with at least one responder, upper lip lift may not be the solution for your situation.  You specifically state that your issues are with expression (smiling), and upper lip lift primarily offers a static change. Instead, I would opt for internal central lip upward mucosal advancement and suture stabilization of nostril rims (with or without alar base resection) to minimize flaring with your smile.  These are office procedures, local anesthesia, magnification for precision.

Ozge Ergun, MD · Answer

Hello.
  
Thank you for the question.
  
 According to the pictures you have shared with us, I believe that the best solution to this problem is an Upper Lip Lif operation. The upper lip grows longer with age, so oftentimes an upper lip lift becomes necessary for people who aren’t content of how thir lips look and what to change it. Upper Lip Lift produces some of the most dramatic improvements seen in plastic surgery today. It is one of those surgeries that can also make you look younger even if performed alone and despite its often times dramatic effect, no one can pinpoint exactly why you look better.  During a lip lift procedure the doctor shortens the distance between the nose and upper lip, allowing also more upper tooth exposure. I am sure that you would get very contenting results.
  
Hope you find this information useful.
  
Best wishes!
  
Ozge Egun M.D
  
Aesthetic Plastic and Reconstructive Surgeon

Farhad Rafizadeh, MD · Answer

I would like to analyze your situation in a bit more detail. Your upper lips are thin except in the central portion where they seem to be of normal thickness. Your incisors are situated a bit higher than where they should be. It would also be helpful to see a picture of you relaxed with your mouth slightly open to see how much teeth you show in the resting position. Your options are central vermilion reduction that would make your entire lip thin. If you cover your teeth in the resting position, it would be better to do a lip lift with lateral lip augmentation. Or if all you want is an even amount of upper teeth show when you are smiling, a lateral lip augmentation would be all you need. Hope this answers your question adequately. Please let me know.

Gary Linkov, MD · Answer

You would benefit from an upper red lip reduction with a focus on the central area where you have extra red lip. An upper lip lift would likely not solve your concerns.
Gary Linkov, MD
Lip Specialist
Manhattan

Jeffrey Jumaily, MD · Answer

I think a lip reduction with or without a lip lift may give you the best results. This problem is not simple and requires excellent technique and judgement. Consider a consultation to discuss the details and options.

Barry L. Eppley, MD, DMD · Answer

The excess mucosal roll that you have when you smile is known as a 'double upper lip. It is caused by an excess of wet mucosal tissue that becomes most apparent when smiling. This is treated by a mucosal roll excision performed under local anesthesia.

The middle of my upper lip hangs down when smiling and covers my teeth. Anything that can be done to create symmetry? (photo)

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