Integrating Orthognathic Surgery Into Lip Lift for Subnasal Aesthetics.

Lip lift is a versatile procedure to shorten the upper lip and improve the morphology and proportion of the lip. It is commonly performed as part of facial rejuvenation in Western patients, whereas in Asian countries, younger people tend to desire a lip lift because a shorter upper lip is considered more attractive. The lip lift carries a risk of an unfavorable aesthetic outcome when underlying skeletal deformities, such as maxillary protrusion and vertical excess, are not addressed, resulting in an undesirable degree of dental exposure. This article described our experience of integrating orthognathic surgery into subnasal lip lift surgery to harmonize the facial profile, highlighting the methods to achieve an ideal dental show with lip lift. Orthognathic surgery was first performed to correct the skeletal deformity. Subnasal lip lift with bull's horn-type skin excision and orbicularis oris muscle resection was then performed as a staged procedure. The degree of Cupid's bow elevation was determined by the amount of skin excised, and incisor show was determined by the amount of muscle resected. Seventeen patients underwent this combination approach, and the upper lip was successfully shortened with appropriate proportions and dental show. Overall, the aesthetic results were pleasing, with high patient satisfaction. Integrating orthognathic surgery into a lip lift aids in the enhancement of perioral aesthetics. Preexisting skeletal deformities need to be diagnosed before the lip lift and should be corrected when indicated.