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Aesthetic facial surgery - The lips

Facial Sculpture Clinic - Dr Joël Defrancq - Jaw surgery and implant reconstructive surgery More than anything else in the face though, the lips are leaning towards more absolute measurements. Again it is not a matter of mathematics, but of overall pleasing facial proportions. The width (volume) of the red lips is approximately equal both from front view and in profile view. In profile the upper lip is protruding twice as much as the lower lip from a line drown from the naso-labial point to the labio-mental fold. The length of the upper lip is usually measured from the naso-labio fold to the start of the red lip. In a young female this is 11-13mm, and the red lip itself is half of this distance: 6.5mm. Total 19-21mm. In a young male this is a bit longer in absolute measurements. When you grow older, the lip becomes longer, and the volume thinner.
To restore youthful lips
Dr Defrancq focuses on three techniques for clearly different indications.

  1. The lip can be made more voluminous with fillers (i.e. fat, no synthetics). Dr Defrancq prefers to use the patient’s own tissue fat transfer for this. This can be reaped under local anaesthesia from under the umbilicus, or from the inner - outer thigh.
  2. When your lips are in a thin line with little volume, a volume restoring roll-out is necessary. The out-roll of the lips involves some more surgery. The surgery needs to focus on a combination of fat injection and mucosal surgery from the inner lip (V-Y ’s) to provide the necessary tissue by out-roll. The lip needs some recovery time and some degree of stiffness and numbness of the upper lip can be around for 3 months. But ultimately the full softness and mobility returns with amazing result.
  3. The lip length can be adjusted through a subnasal approach. A horizontal strip of skin (gull wing shaped) is then removed. The procedure rolls out a bit the upper lip, so the red part increases and the lip projection (pout) is enhanced. The show of the upper front teeth increases 2-3mm. However, the ability for the lip lift to raise the mouth corners or manipulate Cupid's bow architecture is limited. Proper patient selection and careful technique are key.
Postoperative instructions & frequently asked questions

Scar in the upper lip lift?

For some weeks a red line will be visible that gradually will efface. It is a technique sensitive procedure, and stitching the lip muscle to the periosteum-nasal spine is part of it. This little red line can easely be camouflaged with make up.

What about after care?

Patients are discharged with strong advice to refrain from smoking for three weeks. Avoid excessive mimics. Clean incisions with diluted hydrogen peroxide, followed by antibiotic ointment dressing twice daily for one week. Taking arnica tablets, sleeping elevated on two or three pillows, and application of cool moist compresses all help to mitigate swelling, bruising, and discomfort. The Prolene sutures must be removed after one week.