“Something needs to be done to the mouth at the same time that you do the face. Otherwise, not only does it look old, it looks odd.”
Dr. Weston, who is in private practice with the Austin-Weston Center for Cosmetic Surgery in Reston, Virginia., has taught a course on rejuvenation of the aging mouth for more than 15 years and believes that this technique is neglected in standard training programs.
If you have an old mouth sitting in the center of a youthful face, then it still looks old even after a facelift,” he said.
It’s good to get up close and personal
There are eight or 10 different procedures that can be used to rejuvenate an aging mouth, and all are based on the observation that rejuvenation can’t take place from a distance, Dr. Weston said.
“In other words, a facelift will not rejuvenate the mouth. It has to be done directly.”
The problems the cosmetic surgeon needs to address in mouth rejuvenation, due to gravitational effects and changes in the skin over the years, include lengthening and drooping of the upper lip, thinning of the red portion of the lip, wrinkles around the mouth, and loosening in the nasolabial fold area.
“In order to make the older mouth look younger, you have to address each one of those things,” Dr. Weston says.
Putting on the pout
Dr. Weston says, “You have to roll out the lower lip to make it poutier, you have to add fat to the red portion of the lips, you have to add fat under each one of the wrinkles, you have to resurface around the mouth, you have to lift the lip centrally and at the corners, and sometimes you have to directly excise the looseness in the nasolabial area.”
“Not all cosmetic surgeons perform surgery around the mouth and some may be deterred by the risks, he adds. “This is one of the hardest parts of cosmetic surgery, and it takes the most courage to do. For plastic surgeons it’s scary because the scars are potentially right there out in the open.
But the tradeoff for all of cosmetic surgery is a scar that you can see from inches away that’s traded for a better appearance at conversational distance. My experience of doing the mouth is that the scars are excellent, you can hardly find them, and the patients accept those tradeoffs and love the results.”
While some physicians might consider mouth rejuvenation techniques “unconventional,” they have their place in the broad scope of cosmetic surgery,” Dr. Weston states. “Conventional cosmetic surgery will only get you so far. Then you have to think outside the box about what else you’ve got.”
He adds that “plastic surgeons are becoming more aware of the importance of mouth rejuvenation techniques as part of the complete restoration of a youthful appearance and are losing their fear of performing procedures in this part of the face.”
Practice will lead to more development.
“As more surgeons begin doing these procedures, advances will continue,” says Dr. Weston.
“For example, the technique for the corner mouth lift has evolved into a more sophisticated design that leaves the scar right at the border of the lip, where it is nearly imperceptible in the vermilion border.”
Dr. Weston and his partner Harvey W. Austin, M.D., founder of the Austin-Weston Center for Cosmetic Surgery, have developed and popularized techniques for correction of the aging mouth since the early 1990s.
Dr. Austin began his specialization a decade earlier with presentations on the lip lift.
“Today, our group probably does more mouth rejuvenation procedures than any other in the world,” Dr. Weston claims.
Writer: George Weston, M.D.