Is it possible to change the shape of the cupid's bow? (photo)

Question

I am 37 years old and have never been comfortable with the shape of my upper lip. I don't feel that it looks very masculine and it causes me a great deal of frustration. I was wondering if it is possible to increase the width between the two "peaks" (for lack of a better term) of the cupid's bow. I've included a photo of my lips and my ideal upper lip shape. If I could get anywhere close to that I'd be happy. Thanks in advance for any input.

Daniel Barrett, MD · Answer

Hi Mark,The landmarks you speak of, the philthral columns, are part of the defining features of the upper lip and cupids bow. Recreating this in cleft lip patients is an extreme challenge and there are many surgeons who have dedicated their whole careers to this part of the body.That being said, I'm not aware of an operation that could reliable increase the distance between yours without a scar that would overwhelm the improvement you are looking for. Getting filler would likely draw more attention to the area rather than increase the space.I hope this was helpfulDr. Daniel BarrettBeverly Hills, CA

Barry L. Eppley, MD, DMD · Answer

You can change the distance between the height of the cupid's bow slightly through small skin excisions on each side of the existing cupid's bow

Karen Stolman, MD · Answer

Yes, it is quite simple to change the shape of the cupid's bow with a hyaluronic acid filler like Restylane, Perlane, or Juvederm.  I recommend trying one of these fillers before considering anything permanent or surgical to at least make sure you are happy with your new look.  Though these fillers may only last 6-12 months, with repeat injections over a period of years cumulative collagen stimulation will result in some lasting change.  Also, if you can't stand it, they are easily reversible with the enzyme hyaluronidase which most cosmetic physicians carry in their offices.  After you like the temporary filler, you can consider duplicating the treatment with permanent silicone, which I would recommend over surgery.  Surgery carries a greater risk of scar, asymmetry or deformation.

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