The traditional lip lift is called the bullhorn lip lift because of its shape. This technique removes the maximum skin from the midline of the upper lip and tapers laterally with no skin removal at the lateral nose-lip junction. Maximum central resection can produce a triangular shaped upper lip creating a “bunny look”. As a result, the lateral lip may be lower than the central lip creating a downturned appearance. The resulting frown makes the patient appear angry or upset.
Dr. Horndeski invented a new technique customed designed to correct the disadvantages of the traditional lip lift. The eccentric lip lift extends the incision to the lateral sides of the nose. More skin is resected laterally using an eccentric pattern, which is the opposite of the tapered bullhorn. Lateral skin excision pulls up the corners of the lip eliminating the triangular bunny look and frown. Optimally, the upper lip corners should be elevated above the midline lip to produce a smile. This technique avoids separate lateral upper lip incisions to elevate the corners. Lateral lip incisions can destroy the normal white line above the mucosa and may extend lateral to the lip creating visible scarring, the “joker deformity”.
Shortens the nose to lip distance Increase the upper lip fullness
Pre-operative photographs are taken
The patient elevates the upper lip to simulate the desired appearance in front of a mirror
Measurements are taken medially and laterally
The excess skin is determined and incision pattern marked
Local anesthesia is injected
The incision begins at the lateral nose-lip junction, extending inside the nostril and crosses the columella-lip junction to the opposite side
Only excess skin is resected
Nerves and muscles are not cut or repositioned
Two-layer closure is performed
Deep layer of self-dissolving sutures last 6 months to minimize scarring
Buried skin sutures eliminate scars from external skin sutures
The patient is awake and able to drive after surgery
The procedure takes less than one hour
Out-of-town patients can leave the same day, if desired
Patients may return to work the next day
Swelling significantly decreases in about one week
No make-up or ointments are applied to the incision line until it’s completely healed
Local patients are followed with office visits
Out of town patients are followed with serial photographs sent electronically
From January 1, 2015 to December 31, 2015, 40 patients underwent an eccentric lip lift by Dr. Horndeski. 90% were women and 10% were men. Age range from 21 to 80, averaging 40 in women and 31 in men. Body mass index range from 17 to 28, with the mean 21.6 in women and 23.3 in men, with 11% of women and 25% of men overweight. Previous surgeries were lip lifts in 3%, nasal fractures in 7%, rhinoplasty in 35%, and cosmetic in 67%. The amount removed centrally averaged 4.4 mm with maximum 6 mm, right eccentric averaged 8.1 mm with maximum 10 mm and left eccentric averaged 6.9 mm and maximum 9 mm. The difference between the two lateral eccentric incisions ranged from 0 to 2 mm with the right greater than or equal to the left in all cases.
Office visits are complimentary
Out-of-town patients or international patients consultations are available via Skype, Facetime, WhatsApp or telephone
Dr. Horndeski was great. I had both a nose job and chin implant at the same time. Admittedly, I was very nervous (leave well enough alone mentality), but I am so glad I did it. Dr. H told me it would take a year before I would see my final result so I hesistated giving my review sooner. However, a year has passed and VERY happy with the results and glad I did it. Definitely was a great boom to my confidence.
Rhinoplasty
