I am concerned that you are not seeing an ABPS-certified plastic surgeon, and instead are seeing a Dermatologist or physician with other non-plastic surgical training who is giving this advice.You have a thin upper lip, and mucosal advancement will not give you much lip fullness except in one location (unless multiple V-Y advancements are anticipated, in which case you get lots of [irreversible] scarring and not much lip fullness.You have a very shapely upper lip with a relatively long vermilion border to nasal base distance. But unless you think your upper lip is too long, or you have too little upper teeth "show," a lip lift will not make your lip (red part--vermilion) seem larger, this operation will simply shorten your lip and give more tooth show, at the price of a visible scar at the base of the nostrils that requires plastic surgical skills to minimize. Lip fullness (of the vermilion) is another thing entirely. For that mucosal advancement is a weak tool that IMHO is better for fixing localized deficiencies such as after injury or cleft lip repair.For actual lip enlargement that preserves your beautiful anatomy, I would suggest a dermal-fat graft (DFG), which I believe is vastly superior to fat graft injections (another common suggestion), even though both of these are superior to mucosal advancement and any potential improvement via lip lift. For this you will need a donor scar, such as C-section, cosmetic surgery like tummy tuck, or breast lift, from which to obtain a de-epithelialized dermal graft. This graft is your own tissue, can have a bit of fat associated with it (but is predominantly dermis), and actually is placed in a tunnel within your upper lip, giving it a living graft that heals and allows sensory nerve growth and normal feel and softness. Of course there is a donor site, which is why having a prior scar is always a good idea. I have, however, even created a new scar just above the pubic hair which hides in most bikini underwear and swim bottoms, in women who request this operation but do not have a donor scar somewhere on the body.I think you should check around and get a few more consultations. Your present plan strikes me as ill-advised and something that will not make you happy. Then you will be tempted to tell all your friends about "plastic surgery gone bad" when in fact it was you choosing a non-plastic surgeon, getting poor advice, and proceeding with ill-advised surgical recommendations by this "cosmetic surgeon." For a few cases of DFG lip enlargement such as I've just described, click on the web reference link below. Look hard at the credentials of this surgeon; ask if s/he is certified by the American Board of Plastic Surgery, NOT the American Board of Cosmetic Surgery (this "board" is NOT an American Board of Medical Specialties member--and they "certify" lots of doctors who do not have full plastic surgical training and ABPS certification, and why this "board" exists--to try to suggest that they have the skills and full training of plastic surgeons when the majority of their members do NOT. I have an article about Board certification in my articles section on my About page; you may wish to check this out also. Best wishes! Dr. Tholen
