A systematic algorithm for the management of lower lip asymmetry

Area of Science:

• Plastic Surgery
• Facial Reanimation Surgery
• Otolaryngology

Background:

• Lower lip asymmetry, often due to lip depressor dysfunction, significantly impacts function and aesthetics.
• Dynamic surgical techniques for lower lip reanimation show variable success.
• A structured approach is needed for managing lower lip asymmetry in facial paralysis.

Purpose of the Study:

• To retrospectively evaluate outcomes of lower lip asymmetry treatments.
• To propose a progressive, stepwise algorithm for managing lower lip asymmetry.

Main Methods:

• Retrospective chart review of patients with lower lip asymmetry.
• Treatments included lidocaine trials, botulinum toxin chemodeneration, digastric muscle transfer, and depressor labii inferioris (DLI) resection.

Main Results:

• 57 patients received botulinum toxin, 4 had digastric transfer, and 3 underwent DLI resection.
• Patients undergoing DLI resection had prior botulinum toxin treatment and reported satisfaction.
• The study highlights successful outcomes with a graduated management protocol.

Conclusions:

• Optimal management of lower lip asymmetry involves a standardized, stepwise protocol.
• The proposed algorithm progresses from reversible to irreversible treatments.
• This graduated approach leads to high patient satisfaction in managing lower lip asymmetry.