Lip Lift

There is an older procedure also known as a lip advancement that involves cutting at the border of the central top and/or bottom lips. The incision along the central border of either the top and bottom lip, but especially the top lip, is very unforgiving, leading to distortion of the cupid’s bow and visible scarring that can only be covered with heavy lipstick and makeup. Accordingly, Dr. Lam simply does not perform this procedure because the aesthetic improvements are not worth the negative outcomes mentioned above.

Dr. Lam performs a surgical lip procedure usually several times a week and has mastered the art of local anesthesia where you should not even feel his dental block to numb the nerves. You will not believe it until you experience it. He uses a non-burning anesthetic combined with a hand vibration technique where you should not even feel the needle entry. As an exception, the corner-of-the-lip lift incisions sit just at the border of the lip block and you may feel a few seconds of mild discomfort.

The recovery typically has very little pain afterward and usually very little bruising and swelling. If you have significant pain, Dr. Lam has invented a patent-pending method to eliminate pain almost instantly using dilute Botox, which he can perform for you in seconds with near immediate pain elimination. The major issue of recovery is that there will be sutures for the lip lift and the corner-of-the-lip lift that he will remove after a week that will be visible during the first week. In addition, the lower lip advancement sutures on the wet part of the lip are dissolvable sutures that will remain for up to two weeks but are usually not as visible. For the corner-of-the-lip lift and the lip lift incisions, you may put normal makeup over the incisions to camouflage them after 10 days. However, if you purchase a special, healing makeup Oxygenetix that is relatively inexpensive from Dr. Lam’s office you may put it on your incisions as soon as the sutures are removed or even earlier (although the sutures are so visible during the first week that the makeup will really not provide adequate camouflage benefit earlier than the first week). You may shower within 24 hours and resume full workouts in a week. Dr. Lam prefers no swimming for 4 weeks after the procedure if possible. Also, he recommends no activities that risk major blows to the lip for a month like jujitsu or downhill skiing, etc. If you have major social events, he would advise 6 weeks of time to be safe but minor social/professional events can be initiated after sutures are removed usually without too much visibility. Remember everyone’s recovery times are different and variable, and Dr. Lam only would like to provide general guidelines to help frame your thinking and planning.

Not exactly, you will lose about 1-2 mm of elevation of the lip lift after 2 to 3 weeks, so the lip lift will be a little bit more pronounced in the result in the first few days to a week. That may look slightly undesirable or sometimes actually appear more desirable. In either case, remember that it will not be the final result.

The results are essentially permanent. The only thing that will compromise one’s long-term results would be further aging. That will usually take years if not decades of time. However, there will be subtle changes over the years that may benefit from another procedure if you are interested but only after another consultation with Dr. Lam to determine the validity of doing so. Remember that the skin that is removed is permanently gone or the lip that is advanced is also permanently corrected. Only aging will further reduce some of the beneficial effects of the lip lift/advancement procedure.

There is no guarantee that you will show more teeth. However, in most cases, you should show more teeth. Even though the aging lip that covers the upper teeth both when not smiling and smiling is an undesirable trait, Dr. Lam works to shorten the white lip in such a way that your lip appears natural and also so that you can still easily close your mouth. You do not want to remove so much white lip that you show more teeth but you cannot close your mouth normally. Dr. Lam has a precise mathematical formula that he blends with artistic judgment so that you will have a functional result, that is, you should not have any compromise to your lip closure or function.

A gummy smile is a smile in which you show too much gum above your upper teeth when you smile. This is usually not the case that is of great concern with a lip lift since most individuals undergoing a lip lift have too little teeth showing and simply want more teeth showing. That being said, you could have this result, and Dr. Lam always evaluates for this possibility when he performs his initial consultation with you and gives you guidance regarding it.

It all begins with a consultation with Dr. Lam in which he measures your lip to determine how much he can safely remove. In general, he needs to leave behind approximately 11 mm (1.1 cm) of white lip for the lip to be functional. If he removes under 4 mm of lip there is typically not enough difference to justify a lip lift. He prefers to remove between 6 to 12 mm of lip to achieve the best results.

In younger patients who do not have significant downturns of the corners of the lip, this procedure is unnecessary. However, in most individuals who have enough aging to undergo a lip lift and lip advancement procedure, a corner-of-the-lip lift procedure may be considered worthwhile. This is especially true in an individual who needs a significant lip lift (>10 mm) and also has significant downturns of the mouth. If the lip lift is done in isolation, you can develop a rabbit deformity where the center is elevated too much and the sides are not adequately addressed, leaving an imbalanced appearance that is aesthetically unappealing and at times unnatural. Again, Dr. Lam will guide you on whether to undergo this combined procedure.

Dr. Lam performs lip lifts and lip advancements in all races and ethnicities, including Blacks, Asians, Hispanics, etc. However, the white race remains the most common to undergo this procedure because their white lip lengthens the most due to the effects of sun damage on this delicate skin. That is why Dr. Lam refers to it as the white lip but that would apply to any color of skin depending on the ethnicity. The procedure is safe in all skin types.

In general, the answer is yes because even someone who keloids on their earlobes, neck, and scalp usually does not keloid in their central face. That is quite rare. That being said, Dr. Lam can discuss with you after a thorough evaluation of your keloids and keloid history if you are a safe candidate or not. Oftentimes, people use the word “keloid” to describe a “hypertrophic scar”, and the two are not the same. A hypertrophic scar, albeit thicker than a normal, ideal scar, is usually easily managed and is very different from a keloid. For more information, visit Dr. Lam’s keloid page where he specializes in managing keloid scars.

Even if you do not keloid or typically create unfavorable scars, sometimes the incision can be slightly red or thicker in the initial weeks after the procedure and usually will continue to fade over time. Dr. Lam also prefers to use injectable, dilute Botox that can permanently, safely correct scar tissue in all skin types really without risk or additional charge. He can explain more about that when he talks with you or you can learn more about Botox for scars in this video. It is important to know, nevertheless, that the goal for a procedure is not that it is scarless, which is impossible, but for the scar, or incision, to be imperceptible to anyone seeing you from a social distance or even relatively close up after the initial healing period passes.

Lip fillers or fat grafting will definitely make the lips appear fuller but they do not always solve the other problems that a lip lift can provide benefit for, including a shorter white lip and more teeth show. Also, oftentimes a red lip that is almost completely invisible will fail with fillers because a filler will not flip the lip upwards sufficiently to make it more visible. Instead, fillers will just push the lip border out in an unnatural way and only a lip lift can rotate the red lip upwards to become more visible.

Yes, you can do fat grafting and/or fillers before or after a lip lift procedure. However, if too much fat or fillers were placed before or when Dr. Lam pulls up on the white lip with his fingers during his consultation and your lip appears unnatural, he may have you dissolve or surgically correct the filled lips before he performs the lip lift for you. He can also correct the lip fillers/fat/silicone after a lip lift is performed.He will counsel you on the merits of the above discussion during a consultation with him. Please bring your questions if you should have them.

Generally, no. Dr. Lam has either optimally or maximally removed the tissue for your lip lift, lip advancement, or corner-of-the-lip lift. Anything more will not help and risk either an unnatural result, a functional problem (not being able to close your lips), or both. Office-based fillers can be an easy option to further augment a lip or correct downturns of the mouth. Remember that a lip lift does not always provide the volume you are looking for even though there should be a discernable benefit. Based on Dr. Lam’s artistic eye and after consultation with you, he can work with you to decide whether to perform additional fillers or fat to help further enhance your lip lift result.