Mucosal Advancement: What to Consider When Improving Thin Lips

The thickness and shape of the lips vary from person to person, and some people consider improving the shape of their lips for aesthetic reasons. Methods for adding volume to the lips include hyaluronic acid (HA) filler, philtrum reduction, and mucosal advancement, and the approach applied may vary depending on the lip structure and the desired change.

Hyaluronic acid filler is a non-surgical method that adds volume to the lips through injection. It is accessible in that it can be performed without an incision, but in an inverted structure where the inner mucosa of the lip is rolled inward, the result may differ from the expected shape.

In an inverted lip, the exposed area of the vermilion is narrow, so even when filler is injected, forward projection may stand out more than the vertical width. However, the outcome may vary depending on the lip structure, the amount injected, the characteristics of the product, and the procedure method. Filler may be absorbed into the body or change shape over time, and there is also a possibility of swelling, bruising, asymmetry, and vascular complications, so it is necessary to receive a thorough explanation in advance.

Surgical methods include inner philtrum reduction, outer philtrum reduction, and mucosal advancement.

Inner philtrum reduction is a method that excises and sutures the skin in the area beneath the nose to adjust the length of the philtrum and the shape of the central portion of the upper lip. Outer philtrum reduction is a method that adjusts the outer portion of the upper lip to change the degree of exposure at the edge of the lip.

These surgeries are also called "lip lift" in English-speaking countries. Depending on the region and the medical setting, the terminology may be used differently, focusing on either adjusting the philtrum length or improving the lip shape.

Mucosal advancement is a surgery that moves the inner mucosal tissue of the lip outward to widen the exposed area of the vermilion. It is performed by placing an incision line in the inner mucosa of the mouth and suturing it, and it is characterized by not cutting the external skin.

However, even without an external incision, surgical marks or adhesions may remain inside the oral cavity. After surgery, swelling, bleeding, infection, asymmetry, changes in sensation, tightness, and tissue contraction may occur, and the recovery process and the degree to which results are maintained may vary depending on the individual's tissue characteristics and the extent of the surgery.

The difference is that filler adds volume within the tissue, whereas mucosal advancement adjusts the position of the existing mucosal tissue. No single method is suitable for all cases, and the degree of lip inversion, the philtrum length, tooth exposure, occlusion, the condition of the oral mucosa, and the desired change must all be considered comprehensively.

Tak Seung Wan, director of Dr.Tak Plastic Surgery, explained, "The reason lips appear thin may be related not only to a simple lack of volume but also to a structure in which the mucosa is rolled inward." He added, "In such cases, the characteristics of fillers and surgical methods should be compared, and an approach suited to the individual's lip structure should be reviewed."

He continued, "Mucosal advancement is a method that does not cut the external skin, but there is a possibility of swelling, asymmetry, changes in sensation, and intraoral scarring following the surgery." He said, "It is advisable to thoroughly confirm the structure of the lips and philtrum and the extent of the desired change, and then consult with a board-certified plastic surgeon to decide on the method."