There has been a great emphasis on having good-looking teeth. It’s hard to have an attractive smile without them. Frequent flossing and dental whitening are now part of expected personal maintenance. Teenagers want orthodontic treatment. It’s not a stigma. The days of “Austin Powers” teeth are long gone.

Not only is it important that teeth look good, it is important that the teeth are exposed properly when the lips are parted. This is called “upper incisor show.” If the lower teeth are showing, and the upper teeth are hidden, this is an unmistakable sign of aging. When the lips are parted, the lower parts of the upper teeth (“dentition”) should be exposed. There should be no exposure of the lower teeth. Part of the plastic surgeon’s goal, therefore, is to elevate and fill out the tissues of the lips, correcting any flaccidity caused by aging. This is done by fat injection and by the deep plane technique facelift technique, which can provide a small degree of lip elevation. A few millimeters can make a noticeable and pleasing difference.

D.Ni. (Age 51)

Description: Facelift, submental lipectomy, upper and lower blepharoplasties, erbium laser skin resurfacing, pulsed dye laser treatment of face and neck.

Before, 10 months after

Comments: This patient has gained a few millimeters of exposure of her upper teeth after surgery, and cover of her lower teeth, helping to make her look younger than her 52 years.

V.F. (Age 51)

Description: Facelift, submental lipectomy, upper and lower blepharoplasties, fat injection (47 cc), endoscopic forehead lift, and CO₂ laser resurfacing.

Before, 6 months after

Comments: This 78 year-old had the characteristic flaccidity of her lips, caused by aging. After surgery, she has the desired exposure of her upper teeth.