To have full, pouting lips appears to be one of the characteristics for beauty. Inborn thin, narrow lips give a "peaky" appearance and ageing changes the structure of the lips. The subcutaneous tissues and the muscle loose their elasticity due to hormonal changes making the skin thinner and the upper lip longer. The border between the white and red skin of the lip, vermilion or lip roll is in the younger lip well defined and elevated. This structure diminishes with ageing. The described visual changes are not so evident on the lower lip.
There are some different treatments according to the demanded correction.
Broadening of the red of the lip:
A broadening of the part of the lip is only possible with an operation. These procedures are done under conscious sedation and local anaesthetic.
Shortening of the skin at the base of the nose (upper lip):
This operation is only effective on senile lips. A gulwing shaped piece of skin is excised at the base of the nose, which pulls the lip upwards.
Shortening of the skin at the liproll (upper and lower lip):
A very effective method but the scars remains visible and the liproll disappears. This method is not recommended.
Forward transposition of mucous membranes (upper and lower lip):
With multiple V-shaped incisions in the mucous membrane on the inner side of the lip, the membrane can be pushed forward and broaden the visible red lip. This gives no augmentation and the long-time effect is doubtful. If bloodsupply is restricted during healing, indentations in the lip can occur.
Transposition of mucous membranes from the cheeks (upper and lower lip):
From each cheek a strip of mucous membrane is excised and rotated on a stalk into an incision on the inner side of the lip. The red lip is broadened, the fullness is augmented and the effect is permanent. The bloodsupply through the stalks is vulnerable and if hampered parts of or the whole flap can necrotize. This heals with scarring and indentations.
Enhancement of fullness:
All these procedures can be done under local anaesthetic.
You can expect:
- All manipulations of the lips cause a transient, heavy swelling from some day to a week. A certain pain can occur in all procedures.
- After mucosal plasties the lips are swollen for at least one week.
- Liquid food should be eaten the first 3 days.
- If blood supply is constricted, parts of or the whole flap can fall of (necrosis). This will heal with scarring and cause deformities.
- If infections occur, the implants must be removed.
- All implanted material can be felt as an induration in the lips between the fingers on palpation. Foreign bodies or semiliquid material (Gore-Tex, Silicone, and pearls of glass fibres) is more easily palpated and injected material can aggregate.
- Foreign bodies can dislocate.
- The mouth is from the surgical point of view contaminated and in spite of prophylactic antibiotics infections can occur.
