Poorly defined or small lips can be the result of genetics, injury or the normal aging process. Over time, the skin of the lips begins to thin and the lip muscle loses tone, resulting in a flattening and loss of volume. The lip or vermillion advancement procedure helps to restore size and volume to the lips, providing a more permanent solution for youthful lips. Good candidates for lip advancement include individuals with very little mucosal show (the red part of lip) and with a long upper lip (an increased distance from the base of nose to the upper lip border).
Dr. Caniglia’s patients choose to have their surgery performed at the Plastic Surgery Center at Kierland (PSCK). Located in the Caniglia Center in Scottsdale, Arizona, the PSCK is a fully-equipped outpatient surgery center that is licensed by the state and accredited by the AAAHC. Most lip (vermillion) advancement surgeries are performed on an outpatient basis and take between thirty minutes and an hour to complete. Both local anesthesia and/or intravenous sedation (twilight sleep) can be administered.
With the patient in the sitting position in the preoperative room, the amount of skin to be excised from the upper and or lower lips is measured. The patients can have input here as to the size and shape they wish their lips to be. Once in the operating room and after adequate local anesthesia and/or sedation have been administered, an incision is made. There are 3 basic incision locations: (1) underneath the lip; (2) at the base of the nose; and (3) along the lip (vermillion) border. Dr. Caniglia prefers the incision along the lip border as this rejuvenates the entire length of the lip. This incision is well-hidden along the red-white junction of the lip. Furthermore, if a patient wants to change the shape of the lip, making it more prominent or creating a less prominent cupid’s bow for instance, this can be accomplished through this incision placement. Once the incision has been made, the previously marked skin of the upper and or lower lip is excised. The mucosa or red portion of the lip is advanced out and the incision is closed with sutures. The patient is then transferred to the recovery room.
Patients will feel fine the next day, with little to no discomfort. One may experience some temporary tightness along the lip or incision line, however this line will continue to soften over the next several weeks to months. The sutures are removed after seven days and the patient can apply lipstick the next day if desired. Most patients are able to return to work after the sutures have been removed. More strenuous activity and exercise can usually be resumed after seven to ten days. As with many facial plastic procedures, major risks and complications associated with lip advancement are rare but may include infection, bleeding, asymmetry, tightness and noticeable scarring.
The lip advancement procedure can be followed postoperatively with permanent makeup or lip tattooing to further enhance the lips and improve the overall result. Some patients will still desire fillers or plumping agents such as Restylane, JUVÉDERM® and Collagen now that they have lips to plump.