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CosmeticSurg Blog

Dr. Rodriguez discusses Plastic Surgery, Medicine, and Stem Cell Research

Lip Lift Technique: Lifting Skin Only vs Muscle

Patients today are doing a lot of research about the upper Lip Lift. One of the most frequent questions I get is if the surgery involves the muscle of the upper lip. Patients want to know if my technique involves only the skin, or if I lift the muscle in any way. My Lip Lift technique involves lifting the skin only, and I do not involve the muscle.

It seems one of the biggest proponents of technique incorporating the muscle is Dr. Randal Haworth in California. In 2008, he and I met on a trip to China representing the American Society of Plastic Surgeons, and I enjoyed his company. But I have a different approach to the upper lip lift and I will explain why.

Muscles Around the Mouth Area

Muscles around the Lip

Muscles around the Lip

On this photo you can see an artistic representation of the muscles around the mouth. As you can well see it is not just one muscle. All those muscles act in concert when your mouth is moving to speak, eat, or express your emotions. They act in a complex balance of forces, each one acting independently and contributing to the unique way your facial expression works. If they are working well, I see very little reason to mess around with them. Sort of like if it ain’t broke, don’t fix it. You do not need to alter the muscle, because the muscle is not the problem. The problem is the skin.
Secondly, even if I decided for some reason that I definitely must deal with the muscle, there is the issue of the possibility of nerve damage.

Anatomy of Nerves near Upper Lip

Lip Lift nerves

Nerves (yellow) around Lip

If the Lip Lift technique does involve the muscle, consider this photo which shows the anatomy of nerves around the lip area, where the surgery is performed.

You can see the nerves in yellow going thru the upper lip right where the muscle is being worked on. The potential for damage is too much for my taste. I have been performing this procedure with this technique for over 10 years, and I have always been very happy with the results!

My Mantra: I only cut skin, no muscle

If your upper lip is too long, the muscle (or nerve) is not the problem–it’s the long length of the skin space. My mantra is, ‘don’t go looking for trouble where there is none.’ For this reason, I just cut the skin, I leave the muscle alone.

The lift in a Lip Lift comes from fixing the skin of the lip to the septum cartilage of the nose and the though membrane surrounding the nasal bone openings. It is this fixation that prevents distortion of the nose, thickening of the scar, or migration of the scar.

Just take a look at our patients’ results, and remember that after the procedure what your friends will see is not just a picture of your lip, but how it moves.

By Ricardo L Rodriguez MD
Baltimore, Maryland

Ricardo L Rodriguez on Google +

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12 Comments

  • avatar Ricardo L Rodriguez wrote
    April 12, 2014 at 1:16 pm

    Christy:
    I would need to see pictures to be able to suggest the best alternative for you. In general, when there is so much tooth show, the best thing to do is filler. Have you tried fillers? Even if the lip looks too long, once you add vermillion (the red part of the lip) with a filler the proportions may change. one may also consider filing down the teeth if they appear too long. All of these are wild guesses and I would have to see your pictures to give you an accurate idea of what to do.
    And yes we do multiple procedures often and a discount applies to the second procedure.
    I’ll put you in contact with Kelly to see if we can review your pictures. She is at kelly@cosmeticsurg.net

  • avatar Christy wrote
    April 1, 2014 at 1:25 am

    Would you do a lip lift on a 44 yr old female where the distance is 1.55 cm, but when the lips are relaxed you still see half the upper teeth? My upper lip is very thin and the distance to the nose seems too long, but would the lip lift give a buck teeth type of look in this situation?

    I’m considering doing the lip lift with a brow lift to correct eyelid hooding and assume that you can do them together and possibly give a discount for 2 procedures at once.

  • avatar Ricardo L Rodriguez wrote
    September 12, 2013 at 5:31 pm

    S:
    One could possibly release the scar and inject some fat in between so the muscle would not reattach.
    But this is conjecture. To really know more specifically I would need to see pictures and do a Skype to see your lip move. That would amount to a virtual consult. If interested, contact Kelly at kelly@cosmeticsurg.net

  • avatar Ricardo L Rodriguez wrote
    September 12, 2013 at 5:19 pm

    Joan:
    I answered on your other post but just want to add that racial background is not as important in the face and if you use proper technique.
    I have done hundreds of these and scarring has not been a problem.

  • avatar S wrote
    July 22, 2013 at 7:25 pm

    I had a liplift that involved the muscle and then the doctor attached the muscle to the periosteum. Now I can’t move my upper lip normally. I cannot lift it from the center at all. Can this be reversed?

  • avatar Joan wrote
    July 15, 2013 at 6:34 pm

    Hi Dr Rodriguez,
    I may have posted my question on the wrong section. Sorry if this is repeat.
    I am prone to scars. What is the likelihood that i will get scarring with this procedure? Are there times where patients may be better off not doing a lip lift if the changes of scarring are significant?
    I am Hispanis background.

    Thanks,

    J

  • avatar Ricardo L Rodriguez wrote
    February 28, 2013 at 1:31 am

    Interestingly enough, yes.
    I have had an uptick both in requests for information as well as patients booking surgery.
    For men I recommend a lip length more on the order of 1.3-1.5 cm depending on circumstances.

  • avatar Justin Maxwell wrote
    February 27, 2013 at 3:20 am

    Very interesting post Ricardo. I’ve noticed that this surgery has become quite popular even with men recently. Have you had many male clients over the past few months?

  • avatar Ricardo L Rodriguez wrote
    January 29, 2013 at 2:03 pm

    Thanks!

  • avatar Ricardo L Rodriguez wrote
    January 29, 2013 at 2:00 pm

    Olwen:
    Only minimally. There is a procedure called the corner lip lift that lifts the corner.
    You can also inject botox to the muscle that depresses the corner of the mouth. I do this quite a bit and it works well but is temporary (3 to 6 months).
    That muscle can also be resected, but I don’t do that procedure.
    If you are interested in a virtual consult to see what is appropriate for you contact Kelly at kelly@cosmeticsurg.net

  • avatar Elva Quiroa wrote
    January 24, 2013 at 1:40 am

    Excellent information Dr. Rodriguez you are a master doing upper lip lift I am very happy with my results. Thanks!!!

  • avatar Olwen wrote
    January 22, 2013 at 9:41 pm

    Does this improve droop at the corner of the mouth in any way?