How Can I Fix My Lip Incompetence?

Q: Dr. Eppley, Hello, I hope you’re doing well. I have a lip deformity that developed after I underwent double jaw surgery and genioplasty almost a year and a half ago.

At rest, my lips don’t meet naturally and I need to force my lips closed since my bottom lip drags down and rolls outwards which exposes the wet mucosa. Forcing my lips closed causes me pain in my lower lip and chin area.

I’m thinking if I somehow can permanently augment my upper lip it will close the gap I need to force shut therefore reducing my pain. I’m interested to see what the doctor would recommend.

A: i think you have had too many alterations in the perioral region (subnasal lip lift, double jaw surgery, genioplasty) that the structure and elasticity of the lips has been adversely and probably permanently affected. The key for your lip incompetence is not to try and make the upper lip go down to meet the lower lip….as that will never happen and the upper lip already covers all of your upper teeth. The correct diagnosis for your lip incompetence is that the lower lip is pulled down as the excessive lower tooth show demonstrates. Therefore the correct approach, challenging as it is, is to free up the lower lip and try and raise up it higher up. In my experience the only effective approach is vestibular/scar tissue release, dermal-fat graft and a shortening vestibuloplasty.

Dr. Barry Eppley

World-Renowned Plastic Surgeon