This type of lip lift is performed via the excision of subnasal skin to show greater maxillary incisors and roll the lip out to create a greater vertical red lip height relative to the upper subnasal lip. Thus, if the lowest horizontal third of the face is too long and shows the mandibular dentition, include a lip lift as part of the treatment regimen. The incision is caudal to the nasal sill and is barely visible to observers. Lip advancement Lip advancement, by means of excising the skin just above the upper lip vermilion border with advancement of the vermilion border itself, yields poor definition of the white roll. Accordingly, this procedure is a poor choice unless the female patient is willing to outline her lips, either daily or permanently.
Lip advancement is a poor choice for males in almost all cases.
The incisions must be relatively long for each arm of the plasty. Generally, only 3-4 lengths can be created on each side of the central lip only. These lengths should extend from the wet line to within 1 cm of the labial alveolar sulcus. If an implant also is used, it may be placed later in a stage procedure, or simultaneously, if placed anterior to the Z-plasty and anterior to the wet line. If the latter approach is chosen, undermining of the lip will be limited at the time of surgery.