Upper Lip Lift

LIP LIFTING: MARKING MATTERS

The actual lip lift procedure takes about 30 minutes and can be performed with local anesthesia,
although I usually operate with IV or general anesthesia. The crux of this procedure is to remove
excessive upper lip skin just beneath the nose. As the incision is larger in the center and tapers out
for blending on the lateral edges, a specific geometric pattern is used. This pattern resembles a
“bullhorn,” “Angel Wing,” or “Mustache,” and the procedure is sometimes named after one of
these.
It is very important to draw this outline with a marking pen that will not fade with surgical prep, etc.,
as it will serve as the precise template for excision. It is also important to mark the pattern before
any anesthesia and with the patient in the upright position.\
I have seen some surgeons use a simple elliptical incision for this procedure, which does not heal as
well as the precise geometric incision. The preferred incision corresponds to the lower nasal
anatomy and gently tapers out to the lateral nostril. It is also important to make the incision just at
the nasal sill and not extend into or too far above or below the nostrils. Again, marking is everything
in this procedure.
The maximum amount of skin resection is commensurate with the length of the lip. In general, I
usually remove 5-8mm of skin, which can represent up to one-third of the total lip length as
measured from philtrim to vermilion (Figure 1). Novice surgeons should remain conservative in
determining how much skin to remove.

PROCEDURE

A small amount of local anesthesia is injected to provide hemostasis, but not to excessively distort
the tissues. Using a #11 blade, the intricate pattern is incised then removed. Although some
surgeons remove skin and orbicularis muscle, I generally do not remove muscle, as I have seen
abnormal animation occur in excessively operated patients from other surgeons.
A full thickness skin excision is performed using the fine tip of the #11 blade (Figure 2). This is an
adjustable procedure as at this point, the surgeon can estimate the amount of incision show and
remove more skin if desired.
After this skin is excised, hemostasis is performed with microbipolar cautery, as the upper lip is a
vascular area. Next, subcutaneous sutures are placed using 5-0 gut suture (Figure 3). This is
important to bolster the strength of the repair, as this area is subject to a lot of animation. These
subcutaneous sutures also help align the precise pattern between the proximal and distal skin
margins. Final closure is performed with alternating 5-0 and 6-0 gut sutures or the surgeon’s choice  Sutures are left in place about one week. Patients are asked to refrain from significant animation for the first week and to avoid foods that would aggravate the area or require excessive lip movement.

FAQ
Q1 How much does a lip surgery cost in India?
A1 The cost of the lip reduction surgery is around INR 40,000to 50,000+ applicable taxes.
This price gives you a ball-park figure to help you with your decision.

Q2 How long does a upper lip lift last?
A2 only lasts about 6 months

Q3 How much is a surgical lip flip?
A3 A lip flip is an elective cosmetic procedure, so it won’t be covered by insurance. But
because it generally uses very few units of Botox, it’s a more affordable option than dermal
filler.