Comprehensive surgical aesthetic enhancement and rejuvenation of the perioral region.

There has been minimal attention paid in the literature to the aesthetics of the perioral area, either in youth or in senescence. Aging around the lips traditionally was thought to result from a combination of thinning skin surrounding the area, ptosis, and loss of volume in the lips. The atrophy of senescence was treated by adding volume to the lips and filling the deep nasolabial creases. There is now a growing appreciation for the role of volume enhancement in the perioral region and the sunken midface, as well as for dentition, in the resting and dynamic appearance of the perioral area (particularly in youth). In this article, the authors describe the senior author's (BG) preferred methods for aesthetic enhancement of the perioral region and his rejuvenative techniques developed over the past 28 years. The article describes the etiologies behind the dysmorphologies in this area and presents a problem-oriented algorithm for treating them.