A lip lift can be done in one of two ways.
- You can take white lip out directly above the red lip. This normally leaves a visible scar and has less than a desirable appearance.
- A second, much more favorable technique is where there is an excision of tissue just below the nose. This lifts up both the lip as a whole and brings out more red lip into view.
As we age, the upper lip lengthens and the red lip rolls under, giving the appearance of little to no upper red lip and a lengthened white lip. This lengthened white lip requires more pulling action on the muscles that raise the upper lip, leading to a distinctive look of someone who is older. Secondly, as people age, they show less and less upper teeth, and even in smiling, sometimes it requires an exaggerated smile to even see the bottom of the upper teeth. This problem definitely has a genetic component as shorter upper lips show more teeth when people are younger, and therefore more teeth even as the lip lengthens with age.
An older technique for lip lifts takes an ellipse just below the nose and leaves a distinctive, unattractive scar. The newer, more aesthetic lip lift was first described by Dr. Steven Hofflen of Santa Monica, California. In this type of lip lift, the incisions are started at the outside of the nostrils and dart into the nasal cavity on both sides. This technique acts as a Z-plasty which is a great way of having no visible scar. I have done more than 150 of these lip lifts which can be done under local or general anesthesia with minimal swelling and the majority of the sutures out in five days. This is an excellent way to elevate the central portion of the lip.
At the same time as the lip lift, the surgeon can insert your own tissue into the upper lip to recreate the elevations on either side of the philtrum (the dimple in the middle of the upper lip). These elevations are known as Crista. This gives three dimensions to the upper lip and is another sign of youth. A flat lip is an old lip, and a three dimensional upper lip can give a youthful appearance to go along with the elevated red lip and teeth showing when smiling.
This surgery, if done by someone with a great deal of experience, can be both functional and very aesthetically pleasing.