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The creation of the cupid's bow, philtral dimple, and tubercle can greatly improve the central upper lip. The white roll is dissected free as a bucket handle. A crescent of central vermilion is excised and planted as a composite graft to simulate a tubercle. The white roll is sutured to the vermilion, and a full-thickness skin graft is sutured to the new philtral dimple.
Vecchione et al. (Sun,) studied this question.