Can a lip lift help me achieve the look I want to achieve? (photos)

Question

I have a long philtrum and a crooked mouth. This makes me so self conscious that I avoid all photos and selfies. I have no tooth show when I smile. I want a pouty mouth with a lot of tooth show when my mouth is at rest like Adriana Lima (the model in the photos). Would this be possible? Also, can my asymmetry be fixed? As you can see, the right corner of my mouth is lower than the left. What (if anything) can be done to fix this?

Ryan Mitchell, DO, FAOCO · Answer

Hello, With all due respect and only having limited information, my initial impression after reading your question sets off a couple of red flags.  I will take the liberty for speaking on behalf of plastic surgeons as a whole by first telling you that during the consultation process the surgeon is carefully assessing the patient for his or her perceived expectations of the surgical outcome and determining if the patient's expectations (i.e., physical and emotional results) fit the likely realistic outcome of the operation.  Admittedly it is good that you are asking if it is possible to achieve your ultimate goal of correcting your mouth asymmetry and creating a pouty lip appearance and "a lot of tooth show".  However the severity of your self-consciousness whereby you avoid all photos indicates a significant amount of personal dissatisfaction.  Combining your unhappiness with your appearance with the goal of achieving the appearance of someone else may very well be setting yourself up for disappointment if the surgical outcome fails to meet your expectations.  One of the last things surgeons want is a dissatisfied patient due to unrealistic expectations.  Now, let's talk realistically about your anatomy, asymmetry, goals and realistic expectations.  You say that your philtrum is long.  A normal measurement from the midline base of the nose to upper border of the lip (vermillion border) is 1.2 cm (just less than 1/2 inch).  It appears that your philtrum length exceeds 1.2cm in which case there is sufficient excess philtrum skin to remove so as not to create a post-operative short upper lip deformity.  Next, please realize that just about every single person has right to left facial asymmetries.  Very few people are literally symmetric.  In addition, typically it is only the person with the asymmetry that notices their small variations.  On initial view, I see the right corner of your mouth is a little lower than the left corner of your mouth.  The subnasal lip lift will not correct corner of the mouth asymmetry.  However if desired, a corner of the mouth lip lift may be utilized to raise down-turned corners of the mouth or to attempt to correct certain asymmetries.  As for your smile, you do have some dental show currently.  Fortunately you do not have that much dental show so the subnasal lip lift continues to be an option to reach a goal of a larger lip appearance.  The subnasal lip lift will by definition increase the amount of dental show you have.  In addition to the lip lift, you may also choose to augment the volume of your lips.  Your ideal lip appearance has more voluminous upper and lower lips than you currently have.  Therefore if your goal is to try to mimic the appearance of Ms. Lima’s lips the best you can, then you will probably choose to increase the volume in your lips by either using a commercially prepared filler such as a hyaluronic acid gel or by transferring your own fat from an area of your body to your lips.  Finally, let me answer your questions.  You have anatomical findings that are suitable for the changes you are interested in making.  If you underwent a subnasal lip lift with possible corner of the mouth lip lift and increase the volume of your upper and lower lips by adding volume such as a dermal filler, it is possible to change your mouths appearance to share some characteristics of Ms. Lima’s lips and teeth.  It is very difficult and sometimes impossible to correct some asymmetries.  You should definitely allow room for a less than perfect result.  If you cannot accept less than perfection or a result that is not as appealing as Ms. Lima’s then you should refrain from having this surgery and rethink your situation.  I hope my answer was thorough and clear enough to make you feel much more educated regarding your options for lip augmentation.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. You seem like an ideal candidate for lip lift, which can address the symmetry of your teeth, the distance between your nose and your mouth and can be combined with fat injections to create more uniform and volume in your lips. Please keep in mind that what looks best for another person may not be the best look on yourself. Each of us is different and it is important that our facial features respond to one another. I suggest that you consult with a board certified facial plastic surgeon.
Best wishes,

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Can a lip lift help me achieve the look I want to achieve? (photos)

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