Lip lift/ Jaw surgery sequence.

[Milli_Meters]

Hi guys.

I have encountered differing opinions on if required whether a lip lift should follow  double jaw surgery or precede it. What are your opinions? What have surgeons told you?

Thanks.

[boyo]

Always do your bones before your soft tissue. The latter follows the former.

[Milli_Meters]

Always do your bones before your soft tissue. The latter follows the former.

Yes that is my opinion too. 

[The Quest for Aesthetics]

Always do your bones before your soft tissue. The latter follows the former.

Unless you're constrained by time and finance (as I am), in which case get the most pressing issues out of the way (e.g. if you're a female student and your philtrum ruins your looks, but you'll have to wait 2+ years for jaw surgery and you want to enjoy as much of your youth as possible - get the lip lift now). I'm going through soft tissue eye work before upper midfacial augmentation (even though the reverse is usually the way to go) for that precise reason.

[PloskoPlus]

Gunson advises lip lift first.

Correct and it actually makes perfect sense.

[David_D]

Gunson advises lip lift first.

I don't believe that's not the information that he gave to me in consultation - at least not for my own situation.  Perhaps he makes a different call for different people on that question?

[Lazlo]

It makes more sense to me to do it after, but who knows.

the larger issue is that the lip lift is a terrible surgery i would never advise anyone to cause of the heinous scar it produces. Maybe if there were some future method of scarless healing. Also, the problem is that it can severely alter nerve sensation around the upper lip.

[The Quest for Aesthetics]

It makes more sense to me to do it after, but who knows.

the larger issue is that the lip lift is a terrible surgery i would never advise anyone to cause of the heinous scar it produces. Maybe if there were some future method of scarless healing. Also, the problem is that it can severely alter nerve sensation around the upper lip.

The main issue I have with the procedure is that the height of the Cupid's bow is made too high relative to the upper vermillion border in the lateral parts of the mouth. Females are lucky because it happens to produce an effect that can often suit them, but it's not feasible for a lot of men imo. Aesthetic male mouths tend to have a consistent vermillion border across the entire breadth of the mouth.

[Milli_Meters]

The main issue I have with the procedure is that the height of the Cupid's bow is made too high relative to the upper vermillion border in the lateral parts of the mouth. Females are lucky because it happens to produce an effect that can often suit them, but it's not feasible for a lot of men imo. Aesthetic male mouths tend to have a consistent vermillion border across the entire breadth of the mouth.

Corner/medialized lip lift to the rescue.

[Milli_Meters]

It makes more sense to me to do it after, but who knows.

the larger issue is that the lip lift is a terrible surgery i would never advise anyone to cause of the heinous scar it produces. Maybe if there were some future method of scarless healing. Also, the problem is that it can severely alter nerve sensation around the upper lip.

You should check out real self reviews for the procedure. Scar can be managed and for some people it may be necessary because a large philtrum can really mess up a face.

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[PloskoPlus]

I don't believe that's not the information that he gave to me in consultation - at least not for my own situation.  Perhaps he makes a different call for different people on that question?

IMO, your case was quite different.  AFAIR, he wanted to revise your upper jaw only. I guess he didn't feel it was necessary in your case, so he probably wanted you to wait and see till after your jaw surgery if you're still unhappy with its appearance.  But for complex revisions or primaries, the lip lift should be done first.  Otherwise they have to second guess how much tooth show you will have after your lip lift.  Orthognathic surgeons want you to have ideal tooth show, and tooth show has a huge impact on what kind of movements they can do (unless it's a lazy f**k surgeon who just fits one jaw to the other for a solid bite and neglects how they sit in your face).

[PloskoPlus]

You should check out real self reviews for the procedure. Scar can be managed and for some people it may be necessary because a large philtrum can really mess up a face.

But is lip incompetence acceptable?  This is why lip lift followed by jaw surgery is preferred.  The jaw surgery will fix any lip incompetence from the lip lift.

[The Quest for Aesthetics]

Corner/medialized lip lift to the rescue.

True. I'm still of the opinion that men shouldn't alter the lip area too much. Tiny changes here can produce disastrous results. Start adding in multiple procedures and it's dangerous territory. I guess it depends on your starting point and how much you have to lose.

[PloskoPlus]

The scar can be hidden in the alar cinch when performing the lip lift together with a rhinoplasty.  Even when it's not done, some surgeons manage remarkably good stitching.  IMO the bigger problem for a male would be to end up with excessive vermillion, but then some surgeons do a combined vermillion reduction together with the lip lift.

[The Quest for Aesthetics]

The scar can be hidden in the alar cinch when performing the lip lift together with a rhinoplasty.  Even when it's not done, some surgeons manage remarkably good stitching.  IMO the bigger problem for a male would be to end up with excessive vermillion, but then some surgeons do a combined vermillion reduction together with the lip lift.

Does not look good in men imo. Results in a look where the lower central vermillion border is too high relative to the sides of the mouth. Only way is to do lateral vermillion advancement + corner of mouth lift and possibly combine it with vermillion reduction across the breadth of the upper lip it's too thick.