doublelip

Double lip is a rare oral mucosal anomaly characterized by an exaggerated mucosal fold on the inner surface of the lips, most commonly the upper lip. The condition presents as a conspicuous central protrusion that becomes evident when the lip is everted, often described as a second lip. It is typically congenital and may be idiopathic, though acquired cases linked to trauma or habitual lip manipulation have been reported. In some instances, double lip occurs as part of Ascher syndrome, a syndrome that also includes ptosis and blepharochalasis.

Pathogenesis involves mucosal hyperplasia and redundancy of the labial mucosa, producing a folding of tissue that is usually asymptomatic but can be cosmetically noticeable or cause minor functional interference with speech or eating in some individuals. The condition can occur in isolation or as part of a broader syndrome such as Ascher syndrome.

Diagnosis is primarily clinical, based on history and physical examination. Histopathology from biopsy, when performed, typically shows mucosal hyperplasia with normal epithelium and connective tissue architecture, and there are no malignant features. The differential diagnosis includes mucoceles, mucosal cysts, vascular lesions, or other intra-lip masses.

Treatment is generally surgical and aimed at cosmetic improvement or functional relief. Techniques include simple excision or reduction of the redundant mucosa, wedge resections, or other labial mucosal remodeling procedures. Recurrence after complete removal is uncommon. In cases associated with Ascher syndrome, management also addresses eyelid involvement (ptosis and blepharochalasis). Overall prognosis after appropriate treatment is favorable.