Periodontal Lip Lowering - Repositioning Surgery
Technical Connective Tissue Surgery Procedure Discussion
This page contains specific details and extremely graphic pictures that provide the technical detail desired by discriminating patients who are considering connective tissue surgical procedures for altering lip positioning.
The patient had a significant connective tissue problem he wanted to change.
During his consult with the Periodontist, the patient learned that certain perio procedures were available that could create what he had always wanted.... a cosmetically balanced smile.
It was jointly decided that a lip and connective tissue surgery would be provided to reposition the upper lip.
IV Sedation was administered to assure relaxation and comfort during the surgery. The IV sedation coupled with Versed and Valium, as needed, also provided an optimal treatment environment for Dr. Nemeth.
The 2nd photo shows process of making incisions into existing connective tissue that would be altered surgically.
The 3rd picture in this treatment series provides a more graphic representation of actual connective tissue being removed that will eventually create the net effect of limiting the vertical movement of the upper lip.
The periodontist altered the physical properties of the connective tissue relationships based on periodontic standards.
The 4th mid-treatment photo shows the suturing of the newly shortened connective tissues that establish lip movement in relation to the upper jaw (maxilla).
By looking closely at the differences between photos 3 and 4, the deep shadows in the third photo have been eliminated, reflecting a shorter tissue attachment.
This new tissue attachment relationship becomes the foundation for upper lip movement that is more normalized for the patient's facial features and jaw structures. All of the connective tissues that control upper lip movement have been substantially shortened.
The next picture represents the completed perio procedures. All suturing of the altered tissues has been completed.
The suture line indicates the scope of tissue shortening, which runs the entire arc of the maxillary jaw. Specialized Ethicon suture products were used to assure uneventful and thorough healing.
The shortening of connective tissue is now readily apparent. Note how there is no deep pocket between the upper lip and the maxilla.
Since all connective tissues were altered, the muscular movements responsible for moving the lip upwards and for creating smile effects will be uniform. There will be no unusual muscular movements that could cause unbalanced mouth and facial features, especially when smiling.
The 6th picture shows the post operative treatment result, several weeks after surgery.
All of the surgically altered tissues have healed evenly. All signs of surgical treatments are no longer immediately evident.
The upper arch support structures have been effectively changed and provide more normalized lip movements for the patient. Dental function was unaltered.
Our patient was thrilled with the outcome. He now has a smile that shows off his teeth with a smile and smile line that fits his facial features.
The before and after full face photos are paired here to demonstrate the dramatic effects that are possible with specialized periodontic lip repositioning procedures.
Joseph R. Nemeth, DDS
29829 Telegraph Road Suite 111
Southfield, MI 48034-1375
Telephone: (248) 357-3100