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Philtrum reduction
An ideal length of the philtrum is about half of the distance between the lower lip to the bottom of the chin. Philtrum reduction surgery helps create better balance of the face by adjusting the overly long philtrum.
Asians tend to have a flatter top part of philtrum compared to Caucasians, which makes the mouth appear to protrude. This creates a rather stubborn and aggressive appearance. Aging of the perioral tissues reduces the elasticity of the philtrum skin, thins the upper lip and pushes down the corners of the mouth, resulting in a longer philtrum. The philtrum length can also change from the retreating upper jaw and protruding lower jaw after bimaxillary surgery. This increases the nasolabial angle, lengthens the philtrum, thins the upper lip and even lowers the isthmus. Protrusion of the alveolar bone or upper teeth, dental correction of snaggle tooth, etc. can also result in a longer philtrum and thinner upper lip.
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Outcome and surgical method of philtrum reduction
A shorter philtrum makes the face appear younger, smaller, more confident and energetic. The added benefit of this procedure is the thickened upper lip, giving the face a more animated appearance with a fuller mouth.
There are two surgical methods to philtrum reduction; 1) bull's horn incision under the nose, or 2) vermilion border of lip incision.
The under nose incision can be carried out to reduce the philtrum while leaving the upper lip unchanged. The vermilion border incision can be applied when the upper lip is thin with unclear or flat border. Bleeding, edema, infection, asymmetry, relapse, and scarring can occur in rare cases. Side effects also include under-correction, over-correction, and skin bumps. Under nose incision can result in a wider nose or larger nasolabial angle depending on the extent of incision.
-To be continued-
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