Lip Lift

What is a LIp Lift?

Lip lift is a surgical procedure, which aims to reduce the distance between the columella (base of the nose) and the vermilion border (red upper lip line). This distance tends to elongate with age, although it can be congenitally long even in young people.

Reducing the height of the philtrum (upper lip vertical height) can result in a more balanced proportion in the anatomical area between the base of the nose and the chin, and overall can improve the facial aesthetics.

Mr Orfaniotis has developed an expertise in Facial and Lip surgery, and is now one of the leading surgeons in the UK for Lip Lift surgery.

His extensive experience along with his reconstructive backgroung allows him to use bespoke surgical techniques in order to achieve the best results for his patients. Mr Orfaniotis is also able to offer revisional procedures for Lip lifts performed elsewhere, for suitable patients.

Who is a good candidate?

As a rule of thumb, a subnasal lip lift is indicated in patients who have a long philtrum, of more than 15 mm, and this height is aimed to be reduced approximately by one third. These measurements however, may vary on individuals and a thorough clinical assessment is essential. The individual facial characteristics and measurements along with the look that the patient wants to achieve will determine the amount of lift required.

Patients with a long philtrum who previously underwent lip augmentation with fillers may have experienced protrusion of the lip forward rather than an increase of red lip show - a condition also known as “duck lips”. In those patients, a subnasal lip lift can achieve a poutier and more natural upper lip. A surgical lip lift can permanently increase the vermillion show, increase tooth display, and generally improve the facial aesthetics and rejuvenate the lower face.

Patients who experience signs of facial aging may also benefit from Lip Lift surgery.As we age, the changes that occur specifically to the mouth and lip include:

o Loss of upper lip volume with soft tissue descent.

o Thinning of the vermillion border with less definition of the cupid’s bow and philtral columns.

o Bony resorption, which makes the lip look less prominent

o Vertical lengthening of the upper Lip complex, which appears deflated.

o Perioral rhytids (smokers or lipstick lines)

Mr Orfaniotis commonly combines Lip Lifts with other facial rejuvenating procedures such as Face & Neck lift, Periorbital surgery, and fat grafting . You can learn more about facial aging and the Deep Plane Facelift technique by clicking here

Does the subnasal lip lift address the corner of the mouth?

A classic surgical lip lift, also referred as “subnasal”, is very effective in elevating the central part of the upper lip, however it has little effect on the lateral part, at the level of the corner of the mouth. For those patients who have concerns with “downturned mouth” appearance, a corner lip lift may be a better option. A corner lift involves removing a small amount of skin form the corner of the mouth, with the final scar hidden at the junction between skin and vermillion border. Occasionally a subnasal lift can be combined with a corner lip lift for suitable patients.

Subnasal lip lift: How is it performed?

A lip lift is usually performed under a local anaesthetic in an outpatient theatre capacity and lasts approximately 45-60 mins.

The local anaesthetic is administered via the finest needle, the same used for dental procedures. The first injections are performed to the tissue inside the mouth (mucosa), aiming to block the nerves in the area. This is much better tolerated by patients as opposed to inject directly to the skin, which can be very painful. Following the administration of the local anaesthetic and during the entire procedure the area will be completely numb and the patient will feel no pain.

The procedure involves removing a stip of skin just under the base of the nose, also known as “bullhorn” skin excision due to its shape. There are other surgical methods for a lip lift, however the ‘Bullhorn” or Subnasal lip lift technique is the most commonly used. The shape and extend of the excision however needs to be modified to tailor the individual characteristics.

Mr Orfaniotis uses the “deep plane” lip lift technique, which involves releasing of a deeper soft tissue layer, also called the “SMAS”. The SMAS layer is situated above the muscle and is approximated with deep sutures to achieve a tensionless wound closure, whilst the muscle is left intact. Less wound tension means that the risk of scar stretching is lower, and the result can last longer.

In addition, anchoring the wound to a deeper layer at the level of the columella reduces the risk of distortion of the base of the nose and nostrils. Muscle work is not usually needed during a Lip Lift. Manipulation of the Orbicularis Oris muscle during a lip lift may lead to a loss of its function, as well as increasing the risk of a thicker scar.

The wound finally is closed with deep, slow dissolving sutures, followed by very fine, non-dissolvable skin sutures. The later will need to be removed after 6 days.

Click here to see Mr Orfaniotis’ results.

How is the recovery after Lip Lift?

The first few days after the surgery the lip and cheek area will be swollen. The pain and swelling can be mild to moderate, and normally the pain is controlled by simple over the counter painkillers. Very rarely patients need stronger painkillers, such as codeine.

For the first 48 hours is advisable to use some ice packs at home (frozen pea bags are ideal!) and sleep with the head up, supported with a couple of pillows. A soft diet is recommended during this initial period and you may find helpful using a straw to drink water for the first couple of days.

Any strenuous activities including exercise should be avoided for 2 weeks.

An antibiotic based ointment will be given to you upon discharge. This will need to applied to the suture line twice a day.

After 24 hours it will be possible to start washing the area with an anti-bacterial face wash, followed by application of the ointment.

After removal of the skin sutures on day 6 or 7, the same care can be continued for another 7 days.

At 2 weeks after surgery, when the wound is completely dry and no scabs are present, the scar can be treated with silicone therapy and massage.

Silicone strips are preferable, however if it is not possible to wear the strips for many hours during the day, then a silicone based gel can be also very effective. Gentle massage of the area when applying the gel (or over the strip) will help with flattening of the scar in the long term. Silicone therapy can be continued as long as the scar is improving and up to 3 months.

What about the scar quality?

Lip lift result at 3 weeks after surgery. The scar is settling very well and will continue to improve until it completely fades at 12 months.Note the increased red lip show, tooth display, elevation of cupid’s bow and preservation of philtral columns. — **Lip lift result at 3 weeks after surgery. The scar is settling very well and will continue to improve until it completely fades at 12 months.**
**Note the increased red lip show, tooth display, elevation of cupid’s bow and preservation of philtral columns.**

The incision is made into the natural lines and shadows at the columella (base of the nose), nostrils, and can extend slightly to the alar base creases. The scar is very well concealed and with appropriate surgical technique and aftercare it will become inconspicuous after few months.

After the initial period of wound healing and maturation, the scar can be covered with soft makeup during social interaction, until it eventually completely fade after few months.

Lip Lift Scar at 3 months after surgery — Lip Lift scar

3 months after surgery.

What are the complications?

The main complication after a lip lift is a noticeable scar. For this reason patients who have a history of poor scarring (hypertrophic or keloids) are not good candidates. Other rare complications include; infection, delayed healing, asymmetry, under or overcorrection, scar contracture, smile distortion, widening of the nostrils, and distortion of the nasal sill.

Widening of the nostrils is usually evident for few weeks after the operation. It normally settles completely, however, some minor degree of nostril widening or distortion may be permanent. Mr Orfaniotis’ uses a specific technique which aims to avoid any nostril widening in the long term. Occasionally some patients with narrow nostrils to begin with may experience a minor degree of permanent nostril widening . Those patients usually find this widening effect beneficial as it gives a more balanced appearance to the nose.

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