March 26th, 2021 | Categories: Uncategorized
Don’t speak, I know what you’re thinking. Gwen Stefani had facial plastic surgery. And she looks funny now. Shame on plastic surgery. Or at least that is what all the tabloids would have you think. A lot of patients ask me what happened to certain celebrities, and how they can avoid that sort of outcome after their own procedures. In this case, there may be some misunderstanding about Ms. Stefani.
A quick Internet search of photos of Gwen Stefani spanning 20 years reveals that her facial appearance has not changed drastically. However, more recent photos arising from social media platforms like TikTok show an unusual shape to her upper lip, leading some to imagine that she had facial plastic surgery. Some people state that she had plastic surgery in the form of lip fillers, others state that she had a really bad facelift.
Let’s take a step back here. Gwen Stefani is 51 years old. She looks fantastic. Even the most unflattering photos of her show that her appearance seems unnaturally good. Therefore, she must have had plastic surgery, right? Not necessarily. She has excellent facial bone structure. She has a strong jawline that doesn’t masculinize her, and her face is divided fairly evenly into thirds on a vertical perspective. This is what some might consider “ideal”.
However, she does have a “gummy smile”. This is something that can be seen as early as 20 years ago in photos, and when she smiles there is a lot of dynamism pulling her upper lip towards the base of her nose. As do many with a gummy smile, she also happens to have a thin upper lip. All of this can be attributed to anatomic feature called “vertical maxillary excess”. In other words, the height of the mid third of her face may be a bit excessive.
Why is this a bad thing? It may not be. A lot of patients seek treatment for gummy smiles, because they are embarrassed by the appearance of the gingival mucosa whenever they animate. Although this is not an objectively unattractive feature, it does bother some patients. Ideally, would like to see between 4 and 10 mm of dental show of the upper teeth at repose in the female face. When this exceeds 10 mm, it can cause embarrassment or self-consciousness. As a result, there are many options to treat this, from surgical to nonsurgical. One extreme is injecting neurotoxins like Botox, to weaken some of the muscles that pull the lip up, the other extreme is something called LeFort I osteotomy where the vertical height of the maxilla is literally reduced with a bone saw and fixated with screws.
In Ms. Stefani’s case, I imagine she sought the help of a provider who put fillers in her upper lip, but did so in an un-artistic manner. Perhaps the goal was to created something called a “keyhole pout”. A lot of women are seeking this look wherein when you close your mouth a small shadow can be seen between the upper lip and the lower lip in the center. To achieve this, the sides of the upper lip are fuller than the center of the upper lip. This confers something of a pouty-shaped ellipse in lips that may otherwise not have that shape. It is a trending look, but it does not mean its natural, or even objectively unattractive. Whoever injected Ms. Stefani’s lips, assuming she had them injected, was more interested in achieving a trending result, possibly, than an objectively aesthetically pleasant one.
As a fully trained plastic and reconstructive surgeon, I spent many years performing cleft lip and palate surgery on children in the United States and abroad with unilateral and bilateral cleft lips. In bilateral cleft lips, reconstruction may be complicated by persistent deficiencies in the central upper lip. Outside of the medspa universe, a keyhole pout is also known as a “whistle deformity”. This deformity can be a real challenge to revise, and perhaps makes plastic surgeons wince more than the general public. When I see overdone “keyhole pouts”, the first thing I think of is cleft lip and palate reconstruction, not “this is really nice looking”.
For that reason, I would guess Ms. Stefani did not have plastic surgery. Lip fillers do not qualify as plastic surgery. I do feel that lip fillers are superior to any other lip enhancement medium, but it is nonsurgical. Furthermore, I see no evidence that Ms. Stefani had a facelift. When I look really close at her ears and other features of her face and neck, I simply do not be any evidence that a facelift was performed. The same mid facial anatomic features that give her a gummy smile may make this songwriter more resistant to aging, as a key feature in facial aging is recession and shortening of the midface, leading to deep nasolabial folds and hidden upper teeth.
In my opinion, Stefani is resistant to aging. She has not had a facelift. Her lips have been filled to cover up her gummy smile in an un-artistic way.
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