Has the Upper Lip Lift gone Mainstream?

Blanketing Instagram may be the pout of the moment: an ample, upturned mouth revealing front pearly whites. It’s a look that has generated a fresh trend in cosmetic surgery: the lip lift. “Social media is driving a whole lot of esthetic selections,” says Andrew Jacono, a Park Avenue cosmetic surgeon, but “the voluptuous lip is not something you may get with injections. Filling lips only makes them appear to be sausages but doesn’t change their condition. Only the upper lip lift can naturally turnthe lip up and out.” The 30-minute office procedure excises tissue from just underneath the nose to shorten the distance between nose and mouth, causing the top lip to relax a bit, exposing more teeth, or “tooth show.” In Gen Z’ers and young millennials, it gives an ideal selfie pout; in older candidates, it can shave up to 7 years from the countenance ($3,000-$10,000).

As upper lips age, they elongate to eventually hide the upper teeth, while lower lips drop to expose the bottom teeth. Beverly Hills plastic surgeon Randal Haworth says lips, like breasts, go over time south. “When Angelina [Jolie] was 19, she had an insouciant mouth and had the Bardot upper tooth exposure ,” he says. “Nowadays her lip is starting to hide her teeth. It is the same with Jane Fonda.” Jacono offers that face-lifts improve the corners of the mouth but don’t address the problem: “Shortening the top lip is probably the most effective esthetic procedures I really do.”

Some surgeons will work with dentists to coordinate how much teeth to show.

“Showing 2 millimeters of tooth while you are at rest is ideal,says Manhattan esthetic dental professional Lana Rozenberg, who claims patients once requested heavier veneers to push away the lip for pout.

Now the Bugs Rabbit look can’t be avoided can be avoided, with surgeons just like NYC’s Oren Tepper working with esthetic dentist Jonathan Levine to open LipSync. “Ten years past, there was an ‘aha’ moment when hands were an era giveaway. Now we realize the mouth is a lot more telling, ” says Tepper.

A before and after of a conservative upper lip liftA before and after of a conservative upper lip lift
A conservative upper lip lift result accompanying the Hollywood reporter article, performed by another plastic surgeon. result accompanying the Hollywood reporter article, performed by another plastic surgeon.

There is one disadvantage to a lip lift; its scar. “You can hide part of the incision inside the nostrils, but there is usually always some visibility at the bottom edge of the nasal area, ” says Beverly Hills cosmetic surgeon Leif Rogers, adding “If not done properly, it can change the look of the nose. “

Dr. Haworth acknowledged this as a problem about 15 years ago, ever since patients began complaining of this subtle nasal change. He realized there were two factors playing a part in this:

  1. Excess tension around the incision line where the upper lip attaches to the nose and …
  2. When the incision is made into the nose in a good faith attempt to hide the scar.

This led him to evolve his methods as a necessity to meet the increasingly discerning tastes of his patients. “Cutting into the nasal still can be a disaster even though it is motivated by goodwill towards the patients. By cutting into the nose, it breaks the circular stability of the nostril itself thus allowing it to “unfurl” and migrate inferiorly.

Another thing I have discovered is that when a lip lift is performed, it mustn’t just resist the downward forces of gravity but it must also resist the hundreds of thousands of mouth movements that occur per day. That’s why I needed to develop the OOS Upper Lip Lift which involves securing the upper lip to the strong lining of the bone around the base of the nose (periosteum). This technique is clearly superior to any skin-only lip lift whether it is modified or not. This results in a superior results in terms of beauty, scarring, lack of nasal distortion and longevity.

http://upperliplift.com

Beautiful Upper Lip Lifts without scars?

When we choose to undergo a plastic surgical procedure, we do so to get a beautiful result which is balanced for the face and one that is as permanent as possible and one which doesn’t interfere with function. I don’t think anyone would argue with the above. Lips are a unique anatomical future. They connote youth, beauty and sexuality. However, their job is not only to look beautiful, they have to also function. This is contrast to a nose or an ear which have no moving parts. And as a plastic surgeon helping to advance the field of lip reshaping surgery (LRS), this is where the challenge lays. When a patient asks me to make them a beautiful set of lips, I have to ensure:
  • a. A beautiful upper lip
  • b. A beautiful lower lip
  • c. Both upper and lower lips harmonize with each other
  • d. The harmonizing upper and lower lips harmonize with the surrounding face in terms of shape and scale (volume)
  • e. The upper and lower lips continue to harmonize well into the future (akin to a long-lasting result)
  • f. Scars are as imperceptible as they can be
  • g. The chance of nasal distortion and other complications are kept to a bare minimum
  • h. Lip function is retained (perhaps even improved with the new found confidence!)
  • i. Recovery is minimized whenever possible
  • j. A patient’s expectations are aligned with reality.
(Of course, “j.” should be at the top of the list. If a patient has unrealistic expectations, then no matter how successful a surgery is, if a patient in the end is dissatisfied, the surgery is a failure to them). One of the cornerstones of lip reshaping surgery is the upper lip lift. Most of us appreciate that beauty is mostly conferred through shape and less so by colour and volume. The lips are no exception. An upper lip that is considered beautiful on a primal, instinctual level is one comprised of a short nose-to-lip distance, a beautiful “O” arch, a visible vermilion balanced with the size of the lower and, of course, an appropriate upper tooth exposure. Sexy After performing thousands of upper, corner and lower lip lifts, the secret to unparalleled longevity and a naturally beautiful lip shape is stability. One must understand that, like the hands, the lips move hundreds of thousands of times a day- eating, talking, expressing and other things that shall go unmentioned in this post. Therefore, for an upper lip lift to be successful in terms of beauty and longevity, it should not only resist the downward pull of gravity but also be stabilized against everyday movement (which contributes to re-stretching of the lip, obvious wide scarring and downward pull on the nose). The OOS (Orbicularis Oris Suspension) superficial muscle technique provides this very stabilization by anchoring the superficial layer of Orbicularis Oris just below the dermis to the periosteum (or lining of the bone) below the nose. (The Orbicularis Oris is the circumferential, sphincter muscle that surrounds the oral aperture). By stabilizing the lip in two directions bilaterally I am able to customize the curl and expression of the upper lip to make it not only youthful but sensual as well. The two direction approach is analogous to the way a marionette can come to life by the hands and strings which control it. The skin-only lip lift is a far simpler operation to perform and solely involves removing skin and sewing the skin edge of the lip to that of the bottom of the nose. The only thing holding the skin-only lip lift in position are the dissolvable stitches in the dermis which are no match against constant daily mouth movement and gravity’s pull. As a result, there is a far greater likelihood of the nostrils being pulled downwards, obvious scarring, significantly decreased longevity and suboptimal aesthetics.
After a "modified "upper lip lift
After a “modified “upper lip lift by another Beverly Hills Plastic surgeon, which is basically a skin-only lip lift marketed as something other than it really is. Note severe right nostril pulldown with bizarre pleat along with an “A frame” deformity and an exacerbation of her downward slanting can’t of her upper lips.
I can personally attest to the dramatically decreased longevity, unremarkable results, worse scarring and nasal distortion from the thousand or so skin-only lip lifts I performed in the 90s. Though the skin-only  recovery is easier, the current version of the OOS upper lip lift may allow the patient to appreciate results as early as 10 days. Not only does the OOS technique shorten the distance between the nose and lip but it also allows upper tooth show( that goes without saying really), subtle added rollout of the upper lip’s pink vermilion, welcomed narrowing of the aperture of the mouth (that gets wider with age) and even noticeable reduction in the nasolabial folds. Contrary to some misperceptions, no muscle is removed and no cases of permanent numbness or any paralysis ever encountered.
After an OOS upper lip lift by Dr Haworth. Note minimal scar and no nostril descent
Upper lip lift enhancement
After an OOS upper lip lift by Dr Haworth. Note minimal scar and no nostril descent
More and more people are realizing that the upper lip lift( and other LRS techniques) may play as important a role as a facelift and eyelid surgery in facial rejuvenation. Choosing proper techniques, performing them well and understanding how all elements of the lip work together can be the ultimate magic trick to transform a face from “Meh to Mwah”! Dr Haworth July 2018