Lip Reduction – Patient 101 - Jonathan Hall, MD, FACSJonathan Hall, MD, FACS

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The client is given a mirror and asked to repeat this pursing maneuver to a point at which they would optimally like the amount of vermilion show and posture. This is marked by making a line at the pulled back vermillion (blue lines, Figure 15-7, B). To estimate the posterior degree of the incision, the patient unwinds the pursed lips, and another line is made posterior to the "withdrawed position line" (white line, Figure 15-7, C).

If this distance was determined at 8 mm, then at least 8 mm of tissue would be gotten rid of posterior to the wet/dry line, although my experience has actually shown that 1. 5 times the amount measured can be securely gotten rid of (Figure 15-8, B-C). Although experienced surgeons may excise 2 to 2.

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The configuration of the marked location to be excised is a curved ellipse or "smiley face" that is larger in the center and tapers sharply toward the commissure. The width of the curved ellipse is commensurate with the quantity of tissue excess to be removed. The edges of the curved ellipse carefully taper into the commissure so as not to leave a "dog-ear" defect.

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I personally sedate all lip-reduction clients and then penetrate the lips with several milliliters of 2% lidocaine with 1: 100,000 epinephrine (Figure 15-9). This is necessary for hemostasis, pain control, and hydrodissection. A vagolytic drug such as atropine or glycopyrrolate will help in reducing salivation. As the lips are so vascular, I do not use a scalpel or scissors to dissect, I use the radiowave microneedle or CO2 laser (Figure 15-10).

عن طب الأسنان - AboutDent al Twitter: "⚫️ Cheiloplasty: Surgical repair of  injury or deformity of the lips (cleft lip)#Dental_term  http://t.co/Z4Ljw23Ukj" / Twitter

Less bleeding translates into better surgery, less swelling, less pain and bruising, and faster healing. Dissecting  facial feminization surgery  from the submucosa is extremely comparable to peeling a grape or dissecting the skin from the orbicularis oculi muscle in blepharoplasty surgery (Figure 15-11). The layer right away under the mucosa consists of submucosa with plentiful minor salivary glands, and periodically orbicularis oris muscle may show up (Figure 15-12).