Hindawi Publishing Corporation Case Reports in Medicine Volume 2011, Article ID 824634, 3 pages doi:10.1155/2011/824634 Case Report Surgical Management of a Rare Case of Congenital Double Upper Lip Adit Srivastava,1 Ajit Parihar,1 Romesh Soni,1 M. C. Shashikanth,2 and T. P. Chaturvedi1 1 Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India 2 Department of Oral Medicine and Radiology, UP Dental College, Lucknow 227105, India Correspondence should be addressed to Adit Srivastava, dr.adit69@gmail.com Received 27 July 2011; Accepted 19 September 2011 Academic Editor: Carl M. Allen Copyright © 2011 Adit Srivastava et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Congenital double lip is a rare developmental anomaly which usually involves the upper lip. It may occur in isolation or as a part of Ascher’s syndrome. The occurrence of double lip may result in facial deformity especially when patient attempts to talk, smile, or even try to show the teeth. It aﬀects esthetics and also interferes with speech and mastication. Although surgery may be undertaken to facilitate speech and mastication, majority of cases are operated for cosmetic reasons. A case of congenital double upper lip which was surgically treated for cosmetic reason is reported. 1. Introduction Double lip is one of the rarest forms of lip abnormality [1]. The term double lip is used to describe deformity of either upper or lower lip in which a fold of labial mucosa is apparent at rest or at smiling. It aﬀects upper lip more commonly than lower lip and rarely both lips are aﬀected [2]. Double lip usually manifests as two masses of hyperplastic tissue on either side of midline which can sometimes be asymmetrical [3]. Double lip can either be congenital or acquired. Acquired deformity may be secondary to trauma or habits such as sucking lips between diastema or ill ﬁtting dentures. The congenital double lip is believed to be present at birth and becomes more prominent after eruption of teeth. It may occur in isolation or as part of Ascher’s syndrome [1, 4]. There appears to be male gender predilection of 7 : 1 for this anomaly [3]. The treatment is surgical and usually indicated for cosmetic reasons [5]. Recurrence is rare. A case of double lip is reported in a 35-year male which was treated by excision of excess of mucosal and submucosal tissues. 2. Case Report A 35-year-old male patient came to our department with chief complain of deposits on his teeth and also complained that his upper lip was large and unusual because of which he felt ashamed and wanted to get it corrected (Figure 1). There was no family history of double lip and no previous history of trauma or surgery. Upon examination, a thick upper lip was seen with mid- line constriction band between two mucosal bulges which was even visible at rest (Figure 2). There was no blepha- rochalasis and no thyroid gland enlargement. A provisional diagnosis of congenital double lip was made and under dif- ferential diagnosis chelitis glandularis, angioedema, vascular tumors, chelitis granulomatosa, mucocele, salivary gland tu- mor, and inﬂammatory ﬁbrous hyperplasia were consid- ered. His general blood picture was within normal limits. Under local anesthesia, hyperplastic upper labial tissue was demarcated and excised by a transverse elliptical incision from one commissure to another with central Z plasty using blunt and sharp dissection (Figure 3). The minor salivary glands in the ﬁeld were also removed. The surgical defect was closed using interrupted vicryl sutures (Figure 4). A light pressure dressing was placed over upper lip for ﬁrst 24 hours. Histopathological report of the specimen showed normal labial mucosa with mucosal glands and capillaries. Sutures were removed after a week and postoperative healing was uneventful (Figures 5 and 6). Patient was satisﬁed with his appearance and new look. Patient was followed up to 2 years with no recurrence, after which was lost for follow-up.