Modified lip reduction for hypertrophic lip with mucinous degeneration.

Abstract

Hypertrophic lips caused by mucinous degeneration are exceedingly rare and present both aesthetic and functional challenges. Conventional lip reduction techniques primarily target the vermilion, often overlooking hypertrophy of the white lip and deeper tissues, which may result in suboptimal contour correction. A 15-year-old male with diffuse upper lip hypertrophy refractory to repeated conservative treatment underwent a modified layered lip reduction procedure. The surgical approach involved excision of redundant vermilion mucosa combined with selective reduction of subcutaneous tissue, glandular tissue, and segments of the orbicularis oris muscle in both the red and white lip regions. Preoperative and postoperative outcomes were quantitatively evaluated using three-dimensional facial analysis to assess lip volume, convexity, and interlabial angle. Postoperatively, the patient achieved a natural and symmetrical upper lip contour with preservation of oral muscle function. Quantitative analysis demonstrated a reduction in upper lip volume of 1.41 mL, predominantly in the central region. Mean total lip convexity decreased by 3.79 mm, while convexity at the most anterior point of the lip tubercle decreased by 2.34 mm. The interlabial angle increased from 89.8° preoperatively to 108.5° postoperatively, reflecting improved lip-facial harmony. Dynamic smile assessment confirmed preserved mobility and natural lip movement. This modified layered lip reduction technique effectively addresses hypertrophy involving both the vermilion and white lip, achieving precise contour control while preserving orbicularis oris muscle function. It represents a safe and effective surgical option for complex lip deformities associated with mucinous degeneration and may offer superior aesthetic outcomes compared with conventional reduction cheiloplasty.