Cheiloplasty

Cheiloplasty – lip lift-Cosmetic lip surgery

Over time the lips can undergo a resorption process with the result that the face gradually loses its expressivity and charm.
Cosmetic medicine offers many possibilities to restore them by surgical and non-surgical procedures. In this area we will treat some surgical procedures, known all together as Cheiloplasty that allow you to increase the volume of the upper lip and /or lower lip, define lip shape and eliminate imperfections. Reductive cheiloplasty is rarely requested but it indeed it occurs.
Aesthetic defects and solutions
The thin lips are unquestionably unattractive, both for women and men. But other types of defects may also have a very negative effect because of the important role that lips play in the development of the somatic facial features.
Here are some recurring imperfections:
-Upper lips with downward-facing corners (lowering of labial commissure) that give a “weeping” aspect or too severe look to the face
-Deep wrinkles at the lower corners of the lips (puppet wrinkles)
– Lips that have lost volume and softness tend to grow old, even in the presence of a young aspect
-Gingival smile (full denture smile), due to an excess of activity of the muscles that open the smile
– Small wrinkles on the lips and around them, including the so called “bar code”, especially in smokers
-Lips with an irregular border’s shape
– Loss of definition of the shape of the lips or the arc of the cupid
– Flattening or irregular conformation of the two channels between the nose and the lips (philtrum columns)
-Lips too full
-Scar after a trauma or surgery.
Surgical solutions

Some recurrent defects

• Upper lips with downward-facing corners (lowering of labial commissure) that give a “weeping” aspect or too severe look to the face

• Deep wrinkles at the lower corners of the lips (puppet wrinkles)

• Lips that have lost volume and softness tend to grow old, even in the presence of a young aspect

• Gingival smile (full denture smile), due to an excess of activity of the muscles that open the smile

• Small wrinkles on the lips and around them, including the so called “bar code”, especially in smokers

• -Lips with an irregular border’s shape

• Loss of definition of the shape of the lips or the arc of the cupid

• Flattening or irregular conformation of the two channels between the nose and the lips (philtrum columns)

• Lips too full

• Scar after a trauma or surgery

Surgical options

With cheiloplasty by LIP LIFT, it is possible to enhance the red component of the edge (vermillion) removing some skin on the philtrum that separates lips from to nose, so to emphasize the labial crest (Cupid’s arch).
In some cases, some fat by microlipofilling can enhance intramuscular volume of lips or resorbable fillers may be added after surgery. In other cases to define lips permanently by volume it is possible to insert dermal-fat strips Ribbon-shaped by punch incision at the corners of the mouth.
These are the interventions that can be carried out:

V-Y Frenectomy

It is the incision in a plastic V-Y pattern of the labial frenulum and release of the depressant muscles of the septum over the front teeth of the mouth. This procedure allow a lengthening and eversion of the pink border of the lip and a reduction of the “fall” effect of the tip of the nose during smile or speaking.
Bull’s horn approach (“upper labial lift like Buffalo horn”)- Lip lift

With age the labial philtrum lengthens and the vermillion thins, this technique allows a truly remarkable lift of the lips. This intervention ensures a tangible rejuvenation of the upper lip in people with a significant wrinkled labial philtrum labial filter and can also be performed under locale anesthesia or at the same time with a rhinoplasty.
Lip reduction by W- plasty excision
This procedure reduces two prominent lips, reducing their volume and giving a more fine aspect to the mouth. This surgery is preferred by male patients that wants a more masculine aspect of their lips.
Double V-Y lip augmentation
This is a slight surgery that allows you to increase the size of the lips, giving them a fuller appearance. It is done by moving flaps of muscle and mucous tissue from the inner part to outer of the lip vermillion.
Removal of foreign body filler granuloma or liquid silicone from the lips
Many patients comes into plastic surgeon consultation asking for removal of old permanent filler that have received in the years before 2005. Permanent acrylic fillers ( aquamid, bioalcamid) or liquefied silicon have been used frequently many years ago since patients demanded for permanent results when firs collagen fillers could give allergies and first HA filler didn’t last that much. The results sometimes where catastrophic causing granulomas and infection while in other case even though the host didn’t rejected these filler ,tissue reacted with stiffness and loss of facial expression ability. This kind of filler enter the tissue modifying it completely so that their removal may be harmful for closer healthy tissue that cannot be divided from the damaged one. The technique of choice Is a conservative lip reduction whereas the nodules of stiff filler are palpable. Later not early than 3 months it will be possible to help quality of scarring by lipofilling or laser co2 .
Lipostructure or lipofilling
This technique usually adopted in other areas body areas for periorbital rejuvenation or as breast and buttocks enhancer consists in using excess fat taken from liposuction of other the patient body areas. Fat is aspirated in a closed circuit, purified and injected back into the lips, like a filler so to restore their volume and help regeneration of hosting tissues. This procedure is a sight surgical procedure that can be performed under local anesthesia.

Specialist examination

For women and men, lips are among most effective seduction weapons. When it comes to cosmetic lip surgery, however, the risk is to exaggerate and provide the patient with too showy solutions. Dr. Tommaso Savoia always considers the search for a perfect balance between the optimization of the aesthetics of the face and the risk of a fake look.
Thanks to simple but very effective cosmetic lip surgery, facial expressiveness can be significantly improved and give the smile a fresher and more lively impact. In addition, the beauty of the mouth depends on different factors that the doctor will point out with the patient: the proportion between the inner and upper lip, the proportion between the lips and the teeth, shape and volume.
After a careful anamnesis, the doctor may also suggest not to use surgery, but to look for other cosmetic medicine opions.
The approach is always to guarantee the best aesthetic and functional result.
Preparation for surgery
The operation of cheiloplasty is not very invasive and does not require special pre-operative attention for anesthesia.
It will be sufficient to carry out standard blood tests: blood counting formula leukocyte, blood glucose, creatinine, blood urea, plasmatic electrolytes (chlorine, calcium, potassium, sodium), total proteins, liver function (ast, alt), coagulation (pat, PTT).
It will be necessary to notify your doctor of any medication and, if possible, stop using alcohol and cigarettes a few days before the surgery. The use of aspirin or NSAIDs must also be stopped.
Surgery
The surgery lasts about 30 minutes and is carried out under local anesthesia as an outpatient.
Post-operative
The wounds heal in about a week. A mouthwash of iodine or chlorhexidine is required after each meal until the sutures fall.
In each of the mouth procedures, the scars are hidden and the stitches are absorbed. Only in the case of the “Bull’s horn approach” lip lift, it is necessary to remove the stitches after 6 days.
Price
The price of lip surgery is depends on the type of procedure. The cost varies according to whether it is Frenulotomia V-Y, lip lift higher than Buffalo horns, W- plasty excision, Double V-Y lip augmentation, Lipostructure or other operation. The rate can range from 300€ for cosmetic medicine that means lip fillers  up to 3500€ for more complex surgeries.

Before and after