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October 27, 2008

Surgery for thick lips

Illustration by Roberto A. Regachuelo Jr.

Dear Dr. Perry,

I have been reading your column and I would like to consult you about my problem which has bothered me since my college days.

Some of my friends say I am pretty, but I don't go out with them often because of my probem - I have "thick lips." I am so embarrassed everytime I see people laughing when they notice my lips.

Doc, please tell me - Is there any surgical treatment for this, and how much would it cost? Aside from my thick lips, the skin lining my lower lip is also dark. Is there any medication for this?

-Name withheld

lips

Dr. Perry replies:

Oversized, protruding, or malpositioned lips can be a distressing facial deformity for many patients. Etiologies (causes) include obscure types of low-grade inflammatory reactions, congenital lesions such as hamangiomas or lymphangiomas, and racial characteristics, and many cases are of unknown cause. Protruding lips can also result from protruding teeth, and surgical trimming of the lips will not achieve improvement without correction of the teeth malocclusion.

Whether it is racial or congenital (present at birth), full or thick lips may be corrected by a surgical procedure known as Lip Reduction. The operation includes resection of a wedge of mucosa and underlying soft tissue, even including musculature in the more marked defects.

The outline of resection is done in such a way that the resultant scar will fall beneath the lip border and inside the lip with the lips closed. In this way, the scars will not be visible unless the lips are everted.

Before the injection of local anesthesia, the anterior incision is drawn just behind the margin of the wet lines - the area of lip mucosa behind the lip seal region. The posterior limit of excision is determined by the amount of lip mucosa to be removed. Following introduction of the local anesthesia, a conservative strip of the mucosa, underlying glands, and thin ribbon of muscle is removed.

Since this is done under local anesthesia (area is numbed), hospitalization is not necessary. You may go home after surgery and come back after five to seven days for removal of stiches. Costs of surgery will depend on the severity of the problem.

However, if the cause of your thick lips is an inflammatory process (infection or trauma), proprietary medications may solve your problem. Cysts or tumors in the lips are removed by simple excision.

With regard to the dark line in your lower lip, this might be the muco-cutaneous junction which is more visible in patients with full lower lip. This is pushed inside the lip once the necessary reduction is done.

If the dark skin is due to hyperpigmentation from other causes, you may use depigmenting cream or lotion. There are several preparations available in the market, the most common of which are those containing hydroquinone, melawhite, or licorice extract.

Dr. Perry de la Cruz obtained his medical degree from the University of Sto. Tomas. He is a diplomate of the Philippine Board of Cosmetic Surgery; a fellow of the Philippine Society for Cosmetic Surgery and the American Academy of Cosmetic Surgery; and a member of the Asian Pacific Academy of Cosmetic Surgery. He pioneered research on "Serial Revision of Leg Scars" in 1988. His clinic is at:

Asian Hospital and Medical Center
Unit 518 Medical Office Building
205 Civic Drive, Alabang, Muntinlupa City
Telephone no. (+632) 771-9246

Visit his web site at www.geocities.com/docperryster or e-mail him at docperryster@gmail.com.

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