Aging of the upper lip: a new treatment technique

The signs of aging of the upper lip, the pathogeny, and different treatments proposed up to now are discussed. A personal technique used since 1992 is presented. It is based on an earlier personal technique, described in 1970, which consisted of dissecting the skin from the orbicularis muscle and inserting a temporary (three weeks) silicone sheet. The present technique consists of a skin excision at the nasolabial junction, based on that described by Cardoso and Sperli in 1971. However, I dissect the skin of the vermilion border and insert a trapezoidal graft of the pretemporal areolar tissue, taken during rhytidectomy. The graft is fixed with Vicryl sutures at the level of the nasolabial folds. In a few patients this has been combined with a peel. The technique corrects both the superficial and the deep wrinkles caused by the retraction of the fibers that join dermis and orbicularis muscle. It achieves an eversion of the vermilion, enhancing its convexity and producing a fuller look, and shortens the lip, which adopts a concave, youthful appearance because of the improvement of the philtrum and of Cupid's arch. Our technique has been used in 15 patients who were satisfied with the results.