Surgical correction of congenital double lip

Abstract

Double lip is an unusual clinical finding, considered to be a developmental anomaly, and usually involving the upper lip more frequently than the lower lip. It may be seen in isolation or in association with Ascher's syndrome. It is caused by excessive areolar tissue and noninflammatory labial mucosa gland hyperplasia of pars villosa. During smiling, the lip is retracted, and the mucosa is positioned over the maxillary teeth, resulting in “cupid's bow” appearance. The incidence of this anomaly is not known. It has been reported in cleft patients, following lip trauma, and as a consequence of lip-biting habits. It might pose esthetic or functional problems and may be a reason for psychological stress to the affected individual because of over shown hyperplastic lip tissue. Surgical treatment is indicated for the correction of this disfigurement. Various surgical techniques have been suggested to address the double upper lip anomaly. All of these involve the excision of excessive mucosa and the underlying tissue. This case series puts forward the surgical management of this rare anomaly in a relatively simple manner. Double lip is a subject of interest to the dental clinicians because they usually are the first professionals to detect, identify, and treat this uncommon condition.

Botulinum toxin injections for treatment of congenital double upper lip associated with gummy smile.

“…Congenital double upper lip is either due to glandular hyperplasia or the persistence of a sulcus between the pars glabrosa and pars villosa during the second and third week of gestation 9 . It was found out that it mostly appears during smiling or talking due to the contraction of the orbicularius oris muscle 2 Most patients who have this condition is mainly concerned with its esthetic impact and up to this date surgery remains the only solution to solve this condition by reducing the height of the lip from inside, where several publications evaluated the effect of the surgery in treating double upper lip 10,11 .…”