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Lip Reduction Surgery-A Contrary Trend

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We are barraged daily with photos and articles about movie stars and their lips and have become bizarrely infatuated with the subject. Thanks to beauty icons like Angelina Jolie, the poster child for huge plush lips (hers are natural), big pouty lips are in. Unfortunately, this has led to an over-reaction by the public, demanding enormous, unnatural cartoon-like lips from their local plastic surgeon or dermatologist. This has spawned an unfortunate response; "If big lips are good, bigger lips are better and therefore, gigantic lips must be the best (see Trout Pout)!

Filler substances, such as hyaluronic acid (Juvederm or Restylane), medical grade silicone and one's transplanted fat are just a few of the options available to plump the lips. However, what happens when someone realizes that they let their doctor go too far, or worse yet, used an unapproved filler which left them with an undesirable result or deformity? Just like a tattoo (don't get me started on that issue!), unnatural, ballooned lips are much easier to get than they are to get rid of!

While on the subject, there is another segment of society that we rarely hear about; those individuals born with abnormally large lips. I know, the image of natural, large full lips falls right into the cliché' of never being too thin or too rich. However, lip hypertrophy, abnormally large lips, is a legitimate medical condition involving a deformity that can prevent the person from sealing their upper and lower lips closed, sometimes causing inadvertent and embarrassing drooling. They also can interfere with speech patterns and functionality. It can affect anyone, but it is most common in the African -American and Asian population, and is a real problem.
These individuals seek lip reduction surgery from plastic surgeons like myself because they are embarrassed and feel self-conscious. There has been a surge of these procedures in my practice, and similar experience has been reported from colleagues around the country. The actress Lisa Rinna recently publicly chronicled her lip reduction surgery and declared her motives, including the fact that Lisa's overly enhanced lips were getting far too much attention; be careful what you wish for!

Treatment options available for iatrogenic lip hypertrophy (caused by your doctor) and the genetic variety are limited. Deformed lips from over-zealous filling may respond to steroid injections. Lips deformed by silicone migration form hideous lumps called granulomas, just below the lip's outer layer, and must be surgically removed. Lips deformed from numerous granulomas require formal lip reduction surgery, also known as reduction cheiloplasty. The same sort of operation is used for genetic lip hypertrophy.

The surgery is usually performed in the plastic surgeon's office under local anesthesia. Techniques vary, but basically, a wedge of tissue is removed from the central lip mucosa (red lip tissue), and stitched closed, decreasing lip volume. Lip reduction surgery done well, decreases lip size and reshapes excessively large lips to create a more attractive and proportionate lip structure. Generally, scarring is excellent, and the scar can be hidden in the inner part of the lip. The key is conservative excision of tissue, while achieving symmetry, because over-resection of lip tissue can lead to undesirably thin lips.

PHOTOS (courtesy Dr. Tornambe)

All forms of iatrogenic lip hypertrophy are treatable, but prevention is obviously the best route. Those people with genetic lip hypertrophy no longer need to look or feel deformed, as lip reduction surgery is a realistic and effective option. Be certain to choose an experienced, board certified plastic surgeon, who operates in an accredited operating facility.

As is the case for most cosmetic operations or procedures; less is better! If you must plump your lips, choose an experienced plastic surgeon or dermatologist who will listen and respect your desires for a natural look. You can always go back for more. Steer clear from silicone, as complications can be horrendous and appear years later. Observe the other patients in the waiting room, if it appears that you are waiting with a school of trout; Run, don't walk and find another doctor!

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