Everyone knows about lip augmentation, thanks to Kylie Jenner, Julia Roberts, and Angelina Jolie! Lip augmentation can be done with dermal fillers such as Restylane®, JUVÉDERM®, JUVÉDERM VOLBELLA® and Emervel®, or with fat grafting for more permanent results. Both are popular at my Toronto-area practice.
But have you heard of lip reduction?
Here is a quick lesson on lip anatomy. We have the upper and the lower lip. Each lip has a white and a red component. The skin between the red portion of the upper lip and the nose is called the upper white lip. Same goes for the part between the chin and the lower lip. The red lip has a wet-dry delineation, or line. Between the red and the white lips, we have the white roll, or the line where women apply lip liner.
In Caucasians, the lower lip is usually larger than the upper lip. The upper and lower lips can be relatively equal in some ethnicities, such as with Black, Asian, some Middle-Eastern, and Arabic populations and in mixed cultures as seen in Hawaii, Fiji, Brazil, and so on.
Almost never is the upper lip bigger than the lower lip, unless the person has visited a plastic surgeon who is unaware of the natural appearance of different cultures’ lip shapes.
I apply those basic rules of lip anatomy in my busy filler practice in Toronto and Richmond Hill.
With the same basic rules in mind, I also work with patients who want to downsize their lips, so to speak. Some patients were born with very large lips, and some have an exaggerated amount of both the wet and dry red mucosa.
Some others have had older, permanent fillers injected in their lips, which looked fine when they were 35 years old but not so much once they turned 50. There are also those patients who went to unscrupulous or charlatan injectors who used illegal silicone and other non-medical, non-approved materials that caused secondary problems.
Lip reduction is performed most commonly using local anesthesia. The patient and I decide on a reasonable amount of lip reduction. The final scar is at the border between the wet and the dry mucosa and is really hard to see once it is healed. I use a series of very fine sutures that stay in for one week. Although the patient can resume computer use and phone work within a few days, most take the week off as the many little stitches are visible, and the lips do swell up for several days.
In summary, various shapes of lips exist, and I get many requests for heart-shaped lips, long and wide “Julia Roberts” lips, and so on. More recently, there are new requests to shape the lips when doing a reduction — a technique very popular in Asia, where more of a curved shape is given to the pulpous and sexy part of the upper lips.
Lip procedures do require an artist.