A plumper upper lip—without filler—and a bigger, more attractive smile, is what brought Chantal Henderson, an Aspen-based magazine publisher, to New York in the dead of winter last year.
Through friends, Henderson met New York prosthodontist Jonathan Levine, DMD, who said she had a nice smile, but he could make it better. Henderson, Dr. Levine said, would be a good candidate for a procedure he was developing with New York plastic surgeon Oren Tepper, MD. The gist? Dr. Levine would insert veneers on 10 of her teeth, while Dr. Tepper would perform a lip lift, an in-office procedure that surgically shortens the distance between the bottom of the nose and the pink part, or vermillion, of the lip, known as the philtrum.
“Everything was done in one week,” says Henderson, 50, who spent her post-op recovery walking in Central Park, cloaked in a hat and sunglasses, before flying home where she says she’s received endless compliments. “My upper lip is much fuller, but it looks totally natural. People walk up to me and tell me I have a beautiful smile. That never happened before.”
A so-called toothy grin may be one of the most overlooked indicators of a youthful face, but as we age, collagen and elastin break down, causing the philtral length (the groove between the nose and upper lip) to increase, approximately by 1 millimeter each decade. At the same time, “teeth get shorter from wearing, grinding and clenching, we show less teeth during rest, speaking and smiling, and the smile becomes less attractive,” says Beverly Hills, CA cosmetic dentist Matt Nejad, DDS.
To restore a smile, cosmetic dentists make the teeth longer through crowns, veneers or bonding. “Ideally, the amount of upper tooth displayed beneath the upper lip when someone is not smiling varies with age, gender and race. It can vary from 1 to 4 millimeters,” says Beverly Hills, CA cosmetic dentist Laurence Rifkin, DDS. A normal length for a tooth is 10 to 10.5 mm, but many aesthetic dentists bump their size up to 12, or even 13 mm, to provide that ideal “lip in repose” teeth show.
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In order to create a more natural-looking smile, Dr. Levine realized that, by working with a plastic surgeon to raise the patient’s upper lip, he would only have to lengthen her teeth by a little bit. The creation: A protocol for working together, coined “LipSync.” They aren’t the only dentist-plastic duo working in tandem. New York cosmetic dentist Pia Lieb, DDS taps New York plastic surgeon Steven Levine, MD for lip lifts on appropriate candidates, and Dr. Rifkin works with Beverly Hills, CA facial plastic surgeon Ben Talei, MD. According to Dr. Rifkin, the trend is, in part, linked to a bigger movement among dentists to pay more attention to overall facial aesthetics (not just how teeth function).
Thanks to society’s obsession with bee-stung pouts, the lip lift has gone from a rarely performed, stand-alone surgery to a much-buzzed-about way to get bigger lips without fillers. However, it’s not for everyone, and doctors caution that patients with a history of poor scarring should pass on the procedure, as scarring can be unpredictable.
Patients should anticipate having two to four appointments with their dentist (consultations, treatment and post-treatment care) and three with a plastic surgeon (consultation, surgery, post-op suture removal). Most doctor duos work together by emailing 3-D imagery and plans back and forth, and coordinating their surgical and treatment plans. When it comes to what comes first—teeth or lips—Dr. Lieb prefers to finish a patient’s teeth before the lip lift is performed: “You must establish what you can get from the foundation of the teeth and then adjust the lips, whether you start with a temporary Botox lip lift or opt for the more drastic surgical lip lift,” she says. The lip lift is performed under local anesthesia in 30 to 45 minutes, and involves removing a small wedge of skin beneath the nose, shortening the philtrum and slightly rolling or flipping up the vermillion border of the lips, then suturing the incision beneath the nose.
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This 59-year-old patient had veneers and crowns placed by Dr. Levine, and underwent a lip lift with Dr. Tepper. This shortened the distance between her nose and lip to show more teeth when her lips are at rest and when she smiles.
Downtime and Cost
While there’s no downtime associated with veneers or bonding, lip lift patients can expect to experience swelling and discomfort for two days post-op, and should refrain from exercise for 10 days, Dr. Tepper recommends. The full lip lift procedure may cost anywhere between $4,000 and $7,000, but it’s important to note that cosmetic dentistry costs vary by specialist and area and depend on the amount of work performed: Minimal bonding on front teeth can cost $4,000; 10 or more veneers can cost upwards of $30,000.
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