Lip Repositioning (Upper Lip Mucosal Resection)

Treatment details: Lip Repositioning (Upper Lip Mucosal Resection)

There is more than one reason a smile shows too much gum, and the choice of operation follows from which reason applies. Here the tooth length and the gum line were within normal range, and the problem was the distance the upper lip travelled, so a mucosal resection was the appropriate choice rather than crown lengthening. The width of the strip removed decides the result, and it is measured with the patient sitting up and smiling naturally, because the smile changes when a patient is lying down. At one week the lip is still tight and the exposure looks slightly more reduced than it will remain. The muscle relaxes over two to three months and settles at a position a little higher than what is seen in this photograph.

Swelling and tightness inside the upper lip make speech and eating awkward for about a week, and the smile feels restricted during that period. Sutures sit on the inner surface of the lip and are irritating until they dissolve. Bleeding, infection and separation of the wound can occur, and if the wound opens the lip may return toward its original position. The amount of correction is difficult to control precisely, so gum exposure can remain greater than hoped or be reduced further than intended, and the upper lip may look thinner when smiling. Numbness of the inner lip usually resolves. Muscle pull tends to recover over months to years, and a proportion of patients see the gum exposure return.