Surgical Lip Repositioning Procedure to Correct Excessive Gingival Display: A Case Report of Identical Twins

IntroductionExcessive gingival display (EGD) is an esthetic concern for patients with a gummy smile. With the increase in the esthetic expectations of patients, EGD could have an adverse emotional and psychosocial impact. The extent and etiology of gingival display dictate which treatment is indicated. For patients with EGD and a short or hypermobile upper lip, surgical lip repositioning (LRP) is a viable treatment alternative to other more invasive procedures such as orthognathic surgery. The procedure was first introduced in 1973 and resulted in reduced morbidity compared with orthognathic surgery while resulting in predictable improvement. LRP reduces gingival display by restricting the pull of elevator lip muscles and shortening the vestibule, thereby decreasing the range of motion of the lips and decreasing the amount of gingival display. Case PresentationThe current report evaluates the esthetic results of LRP surgery on identical 27-year-old twin sisters exhibiting severe vertical maxillary excess (VME) and hypermobile upper lip. Both patients were given the option of orthognathic surgery to correct their VME or LRP to reduce their gummy smile and improve esthetics. Both elected LRP to address their gummy smile and avoid higher morbidity and costs associated with orthognathic surgery. ConclusionBoth patients achieved acceptable esthetic results that were stable at 12 and 24 months.