Upper lip shortening combined with Lefort 1 maxillary intrusion: A novel approach to correct the long face syndrome

Abstract

Lip lengthening is a common characteristic of aging caused by the weakening of the fascial attachments and decrease of lip volume. We report a comprehensive combined plastic-orthognathic surgery of a long face syndrome uncharacteristically associated with a long upper lip in a 37-year-old Caucasian woman. The deformity comprised increased lower face height, vertical maxillary excess, and increased gingival display upon smiling. The long lip (30.7 mm; norm, 20.1+2 mm) constituted a limitation to the routine maxillary Lefort impaction because of the expected deficient display of maxillary teeth at rest and during smile. Lip shortening (5 mm) through a crescent flap was combined with maxillary impaction (6 mm), mandibular advancement (8 mm), and genioplasty (8 mm). Post-treatment results revealed normal relations between the upper lip and both the lower facial features and the dentition, at rest and during smile. Research should explore the predictability of the observed hard and soft tissue changes in similar dysmorphologies. Level of Evidence: Level V, therapeutic study. © 2013 Springer-Verlag.