Three-dimensional Perioral Assessment Following Subnasal Lip Lift

The sub-nasal lip lift is a surgical technique that elevates the "lip line" (interface between vertical maxillary incisor height and upper lip) to achieve a more youthful aesthetic. This study offers the first ever definition of 3D changes to the upper lip due to sub-nasal lip lift. A lip lift procedure was performed (on cadaveric samples) in a sequential manner from 2.5mm to 5.0mm intervals (n=13). 3D photographs were taken using the VECTRA H1 system (Canfield Scientific, Fairfield, NJ), and 3D analysis was performed including vermillion height and width, philtral height, sagittal lip projection, vermillion surface area, and incisor show. A subset of samples (n=9) underwent a modification of the technique by undermining of the upper lip subcutaneous tissue off of the underlying muscular fascia. Vermillion surface area (baseline ranged from 1.45 - 5.52 cm 2) increased by an average of 20.5% and 43.1% with 2.5 mm and 5.0 mm lip lift, respectively. Anterior projection of the vermillion increased in all cases by an average of 2.13mm and 4.07 mm at 2.5 and 5.0 mm respectively. Philtral height decreased in all cases by an average of 3.37 and 7.23 mm at 2.5 and 5.0 mm, whereas incisal show increased on average of 1.9 and 4.09 mm, respectively. This study is the first to define the 3D morphometric changes to the upper lip following sub-nasal lip lift. Quantifying these changes aids the surgeon in both preoperative planning and guiding patient expectations.