Will Lip Augmentation (Possibly Via Injections) Make my Lips Close Naturally? (photo)

Question

My lips have never touched at rest. My bottom lip is very full and my top lip quite thin, so I was wondering if I got my top lip augmented, maybe my lips would close naturally. I can force them to close, but then my chin looks odd- dimpled from mentalis strain. The lip incompetency really messes up how I look. I need a solution that won't alter my face too much or be too costly. Jaw surgery isn't necessary- I have a perfect bite from having braces. If only I could get my lips to close!

S. Larry Schlesinger, MD, FACS · Answer

OMG.  I meant to write this up years ago.  Chin implants, in my practice, have corrected lip incompetency 100% of the time.  You have a long distance from your lip down to the bottom of your chin, and a retrusive chin.  A chin implant, probably a #2 or 3, chin jowl, will correct your retrusive chin, will visually shorten your overly long lower face, and correct your lip incompetency all at the same time. 

	In my practice, the implants are placed through an intra oral incision and anchored in place with a titanium screw.  No visible scars, quick recovery.  The whole surgery takes 30 minutes.

	Unfortunately, filling your upper lip will do very little to correct this incompetency.  Also, the funny look of your chin when you try to close your mouth is due to the mentalis muscle fibers furiously working to elevate your lip which can be done easily with a silastic chin implant. 

	Please get a consultation with a Board Certified plastic surgeon in your city.

Larry S. Nichter, MD, MS, FACS · Answer

Although your appearance will be helped with fillers or other form of upper lip augmentation it will NOT completely correct your problem with closure of your lips at rest. This condition is called a "Gummy Smile" and usually do to a vertical excess of bone from your upper jaw (maxilla). Shortening this distance will correct your facial harmony at the same time allowing your lips to close naturally. A chin implant will also help your profile, but I disagree with one of the experts who thought this alone will correct your problem. An Orthodontist, Plastic Surgeon with Craniofacial experience or an Oral Maxillofacial Surgeon should be consulted to figure out what is best for you.

David Hansen, MD · Answer

Filling the upper lip with fillers such as juvederm/restylane/belotero ($550/syringe) does great for 4-6 months. Placing a permanent implant in costs rougly $1500-2000 and takes about 20 minutes under local anesthesia and lasts forever. Sincerely,

	David Hansen,MD

Craig Mezrow, MS, MD, FACS · Answer

There are variety of products that can be used to enhance or augment lips as well as improve symmetry.  It is recommended to be evaluated and discuss appropriate options with your physician.

Jon F. Harrell, DO, FACS · Answer

Your issue, based upon the photos provided seem to indicate an underlying skeletal issue. Lip incompetence is frequently associated with a retrusive chin and can often be improved with chin augmentation or advancement of the bony portion of the chin. Your orthodontist would have evaluated all of this when you were in braces. Typically they work closely with oral/maxillofacial surgeons and plastic surgeon who specialize in this kind of surgery. You may also have a relatively elongated mid-face and this can also be approached surgically. However these jaw surgeries can be involved and relatively costly. Not every patient will commit to these kinds of procedures. First find the correct diagnosis, get all of your options and then make an intelligent, informed decision regarding treatment. I would follow up with the orthodontist, see an oral surgeon and a plastic surgeon and by then you should have a good idea of which approach you favor. Fillers would be the last option and the least likely to make a large improvement in my opinion. Best of Luck Dr Harrell

Steven Wallach, MD · Answer

Lip augmentation may help a bit, but a perfect bite from orthodontic work does not necessarily mean your jaw and maxilla( bone with upper teeth) are in good alignment. Your probably first need to be evlauated for vertical maxillary excess and obtain cephalometric x-ray studies. Fillers will only be "cheating" and not quite get you closed properly. Certainly it could be done nicely in addition to the above evaluation.

Kevin Tehrani, MD, FACS · Answer

What you are trying to achieve can be done with a combination of injectables. For your upper lip, you can undergo Restylane or Juvederm (lasts longer) as well as Botox to lower the mid portion of your upper lip. In addition, you may undergo Botox injections in the mentalist muscle (chin) to decrease the prominence and further close the gap. Please look for an advanced injectable practitioner for providing these services. Best of luck.

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