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

An illustration showing facial muscles surrounding lips.
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

An illustration showing the nerves around the upper lip.
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: 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 tough 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 Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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