IMCAS Asia 2012 / Schedule-at-a-glance
KWON Taek Keun
||IMCAS Asia 2012
||SESSION 28 (View)
||lips & peribuccal rejuvenation
||mouth corner lift
||October 6, 2012 11:02 AM
Up until now, mouth corner lift couldn't be widely used due to its ineffectiveness and high risk of side effects such as scars. Even if smas and skin tightening are performed during facelift, there is no change on mouth corners. When mouth corners are not elevated, effectiveness of facial rejuvenation falls short, and complaint of patient increases.
Even for young people, congenitally sagged mouth corners are quite common. Downturned mouth corners give off gloomy and melancholy impression. On the contrary, upturned mouth corners create bright and smiling appearance as well as confident expression.
The reason why mouth corner lift has failed until now is because only physical lifting was performed. Just like endoscopic forehead lift, physiologic lifting must be realized in order to raise the mouth corners and prevent them from moving down again. Around the mouth corner, there are mouth corner depressors and elevators. Although there is risorius muscle responsible for pulling the mouth corners sideways, its existence is variable. In order to lift up mouth corners, strength of elevator muscles must be greater than that of depressors, and vector of elevation must be efficient.
Before performing mouth corner lift, analysis of the condition of muscles around mouth corner is essential. First, when the patient is asked to smile, state of mouth corner elevators and their relationship to depressors can be known. Ask the patients to smile naturally, and observe the movement of mouth corners. Then ask them to smile by applying force on the mouth corners, and watch for the direction of shift and shape of mouth corners. Strong mouth corner depressors do not allow mouth corners to lift even during a smile and sometimes even cause them to move down, and they make the shape of mouth corners appear rounded, rather than sharp.
The operation induces physical lift of mouth corners by resecting the skin in triangular shape above each mouth corner, and then risorius and depressor muscles are cut. Then the muscle stumps attached to mouth corners are shifted and fixated on mouth corner elevators. This way, weakened force of depressors relatively strengthens the force of elevators, resulting in physiological lift. Surgery is performed under local or IV sedation.
Mouth corners lift up very naturally after surgery, and although mouth corners stay upturned on an impassive face, they lift up even more distinctively during a smile. Also, mouth corners lift up when the person is speaking, creating confident facial expression. Possible postoperative side effects include scar, erythema, undercorrection, overcorrection, asymmetry, et cetera, but satisfaction level concerning surgical outcome is very high.
It is very difficult to elevate mouth corner by just excision and closure of the skin around the mouth corner area. To turn up the mouth corner effectively, it is necessary to weaken the lip depressors to gain unopposed mouth corner lift.
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this work was not supported by any direct or non direct funding. it is under the author's own responsibility