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Correction of the shape and volume of the lips (cheyloplasty)

Chalinoplasty includes a complex of surgical techniques used to achieve an aesthetically favorable shape and volume of the lips. Procedures for the correction of the lips deformation, their asymmetry, and local or total volume insufficiency are performed. These situations can be either congenital or acquired, as a consequence of a variety of reasons. As a result, most of the aesthetic problems can be solved by filling the missing volume using rotation of skin grafts or mucosal segments and excision of scar tissue areas.

Most of such operations are performed under local anesthesia on an outpatient basis. Typically, the patient leaves the clinic on the day of surgery. Postoperative curation depends on the difficulty and traumatism of the manipulation. In most cases, postoperative period proceeds with moderate or severe soft tissue swelling, which requires medical manipulation. Sutures should not be removed after surgery; they resolve on their own in 2 weeks.

Bullhorn is surgical method of shortening the upper lip (the distance from the lower edge of the nose to the red border of the upper lip is meant).

The long upper lip can be a consequence of congenital facial imbalances, or it may increase with age, due to the relaxation of the soft tissues. This lip closes the dental arcade almost completely and tucks the red border inside, thereby creating an undesirable appearance. Bullhorn procedure is aimed at shortening the soft tissues of the upper lip, which makes it possible to open the dental arcade slightly, and push a red border of the upper lip forward.

The external marking is done before the surgery. The length and width of the dissected dermis graft is marked. Next, a local infiltration or regional anesthesia is made, with the ongoing excision of excess skin fragment. After pulling the soft tissues up with the internal sutures, it is possible to form a thin vulnerary strip just below the lower edge of the nose. The sealing of the wound edges is performed using the continuous intradermal suture. The threads dissolve on their own within 2 weeks. Formation of scar proceeds smoothly, and it becomes virtually invisible within 2 months.

Italian bullhorn is modification of the classic bullhorn. This operation aims to lift the lateral (side) section of the upper lip only. A distinctive aspect is performing of two short non-conjugated incisions at the transitional furrow of the nose alae. The cut is not performed on columella (nasal septum). This significantly reduces the rehabilitation period after surgery.

Vermilion lifting (Galving - lip - lifting) is a surgical technique used for the correction of forms of both upper and lower lips. The procedure is indicated for patients with anatomically narrow lips. Methods of volumizing (increase in volume) with contour fillers do not allow to achieve the desired stable effect. First of all, this is due to the small size of the recipient area, as well as plastic fillers used are not able to push and lift the red border and to give expression and outline the lips. Therefore, in order to achieve the desired effect, a preliminary surgical stage should be performed for patients with narrow lips. Also, such an operation is indicated for aged patients when the atrophy of upper lip soft tissues leads to a blurring of the contour and smoothing of the swab along the red border.

Vermilion lifting of the upper lip is made more often. The procedure is performed under local anesthesia. The excision of excess tissue is made according to the preliminary external marking. The red border of the lips is being pulled up and expanded in a staged manner. The internal sutures are used for fixation. The continuous suture is applied onto the skin after the coaptation of the wound edges. Typically, the patient leaves the clinic on the day of surgery. The postoperative period is accompanied by the development of moderate swelling. The sutures dissolve on their own in 2 weeks.

V-Y Plasty is a surgical method used for form and volume correction of both the upper and the lower lips. The method makes it possible to enlarge visually the volume of lips by transposition of tissues from the inner part to the outer part of the lip.

The operation is performed under local anesthesia. The incision is made in the shape of the English letter V on the inside of the labial mucous membrane. The mucous membrane is sutured with single interrupted sutures, thus forming an English letter Y. So, the tissues are being lifted up, increasing the volume in the concerned area in a staged manner. The incisions cannot be seen from the outside. Scarring on the mucous membrane is passing smoothly, and the traces of incisions disappear virtually a week after the procedure.

The additional volumizing fillers may be used if the lips have a small original volume; it allows to achieve a more comprehensive result.

Material prepared by
specialists of the Clinic for Plastic Surgery
21-09-2016