24.0: Thursday, March 17, 2005

Modified Lateral Lip Lift

Michael Bain, MD, MS and Robert X. Murphy, Jr, MD, MS.

Purpose: Perioral rejuvenation is an increasingly popular cosmetic procedure. There are various options for lifting the lateral portion of the upper lip. Methods: Patients are candidates for this procedure when they exhibit a long labial ledge, down-turned oral commissures, perioral rhytids, and thin lips. Surgical markings are made in an upright position. Midpoint of the columella is marked; an ellipse of skin is designed around alar crease, 1-mm below nostril sill. An incision is made and deepened through obicularis muscle, avoiding branches of facial artery to columella. Philtral columns are not violated. The incision is terminated low in alar groove to avoid injury to lateral nasal artery. A muscular shelf is created and sewn to periosteum with 4.0-clear nylon. Deep and dermal 5.0-vicryl sutures are directed medially to remove any dog-ear. Skin sutures are removed on postoperative day 5. Results: In two cases this procedure was performed in conjunction with rhytidectomy and lip enhancement with noticeable improvement in correcting frowning appearance characterized by down-turned corners of mouths with flat philtral columns. Conclusions: This technique can provide this desired effect without obliterating white roll of lateral commissure or jeopardizing blood supply to columnella thereby avoiding compromise of future open rhinoplasty incisions.