Abstract

There are noticeable differences in the perioral morphology of males and females, a contrast which is particularly apparent in the upper lip. Specifically, the female upper red lip tends to be fuller, with a shorter vertical cutaneous component and more dental show at rest. Familiarity with these differences, aesthetic ideals, and underlying anatomy is critical for the optimal planning of gender-affirming facial surgery. This article will review the evaluation of the perioral area and discuss operative planning. Multiple surgical techniques will be described in detail, including the commonly performed lip lift via a “bullhorn” incision. There are noticeable differences in the perioral morphology of males and females, a contrast which is particularly apparent in the upper lip. Specifically, the female upper red lip tends to be fuller, with a shorter vertical cutaneous component and more dental show at rest. Familiarity with these differences, aesthetic ideals, and underlying anatomy is critical for the optimal planning of gender-affirming facial surgery. This article will review the evaluation of the perioral area and discuss operative planning. Multiple surgical techniques will be described in detail, including the commonly performed lip lift via a “bullhorn” incision.

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