Dr. Sam Lam Plastic Surgery Forum

hi, i was wondering is it possible to reduce the size of lips?
pls see this photo http://img.medscape.com/pi/emed/ckb/pla ... 4-1480.jpg
do u think it d be possible to reduce the upper lip so as to make it flatter and less 'simian-looking'?
thank you.

in short, yes. i do this several times a week. it is my specialty. if you like to schedule, just email constanze@lamfacialplastics.com or call my office 972-312-8188. i book out a few months in advance so please give me lead time.
best,
sml

hi, i was actually inquiring because i already met and talked to a few surgeons and from what i understood all they can do is reduce what they call red lip and i'm not sure that would make the whole upper lip flatter because they'd have to reduce the so-called white lip too. what do you thinK?

ok, i see your point now. you are talking about the slope from the nose to the teeth from the side view. there are 2 ways to address that slope. a premaxillary implant under the nose will bring the bottom part of the nose forward so that the incline of the slope is less. in the photo you showed, i would not do that because the nose is already tilted up. that would make that condition worse. when the nose is tilted down, the premax implant works better. second, i used to use much larger silicone implant blocks but patients were annoyed when they smiled making me remove almost all my silicone premax implants. today i used minced cartilage but that has less reliable degree of change to the premaxillary implant. if you want to read further about premaxillary augmentation just type "premaxillary augmentation" into google and my article is #1 on the search.

secondly, by reducing the red lip which is the most accentuated part of the lip, there is a chance (and i emphasize chance) that debulking the lip can reduce the anterior-posterior projection of the lip. is that a guarantee? no. the goal is to reduce the red lip bulk but oftentimes the lip settles further back in an A-P dimension. if that is your principal concern however and it is a deal breaker if the lip does not fall back, then don't do a lip reduction because that is not a guaranteed outcome but then again what is per se. hope that helps.

btw, you can't further reduce the white lip, or your red lip will flare even more and become bigger. the problem is not in the white lip. it is a deficiency of the premaxillary bone (but as said in the photo augmenting that would not be advisable) and a protuberance of the lip as well as some possible maxillary fullness right above the teeth. that is something that only an oro-maxillofacial surgeon could address if they see fit.

all right i see. i assume it wouldnt be possible to do the same as you'd do in a red lip, that is excise a strip of tissue from the white lip?

the point that i made is that i can but it will make your red lip turn out more. in short, it will defeat the purpose and worsen matters. plus it is not a vertical shortening of the white lip that you need it is pushing the upper white lip outward (which i can't do based on the nose position) or thinning it down which also is not easy to accomplish, near impossible.

and if you combine both, removing tissue from the white lip then the red lip? what i've observed is my teeth are fairly backward and it's really the lip that's too thick or something

i would only be reducing red lip not white lip. not technically possible. if your teeth are back, that's a good sign.

hi,
what do you mean a good sign?

that means that the fullness in the lip area is probably mainly due to full lips rather than protuberant bone area pushing out. if it were a bone issue, you would need a LeFort osteotomy to push the bone back, something that is far more invasive and that i cannot do. if it is a soft-tissue lip issue, then i can more readily reduce it hopefully to your satisfaction.
best,
sml

hi dr. lam!
i know this picture that was tagged here, it's from an artical of Vipul R Dev, MD, published on eMEDICIN. during my research i saw this site:
http://emedicine.medscape.com/article/1288624-media.
according to the site, that women had already a lip reduction .

vered

ok, i see the before and after. i think the reduction is reasonable. she has a very thick quality to the lip. it may be hard to get a better result in her case.

Hello Dr. Lam -

could you tell me just one thing : you know that procedure call a lip lift? According to what I saw and understand, one of its effects is that the lip turns out more. My problem is not only that my upper lip (white and red lip) is too thick, but that it does turn out, which gives me a bit of a feminine and pouty look. Could you imagine doing something like a lip lift but on the inner side of the lip? The way I see it, it could flatten the lip - not only by removing some tissue but also by pushing back onto the teeth. What do you think?
Best regards,
k


PS:
see this image here http://img833.imageshack.us/img833/3161/26618165.jpg
it may not be the best example but it shows roughly what I mean. In red the upper teeth, in green the lip and in blue the strip of tissue you could excise.

dr. lam wrote:the point that i made is that i can but it will make your red lip turn out more. in short, it will defeat the purpose and worsen matters. plus it is not a vertical shortening of the white lip that you need it is pushing the upper white lip outward (which i can't do based on the nose position) or thinning it down which also is not easy to accomplish, near impossible.

i haven't reviewed the entire thread of discussion but in short a lip reduction is a "reverse lip lift" since i am removing tissue from below rather than from above. however, about "pushing back on the teeth" i don't know what you mean.
best,
sml