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Background: Majority of macrocheilia is seen as normal ethnic variations in Afro-Caribbean and Asian populations. Various other aetiologies have been reported, which include glandular hypertrophy, vascular malformations, granulomatous disorders and trauma. Congenital causes include double lip and labial pits. Clinical features mostly are related to aesthetic problems but functional problems due to incompetent lips like drooling and speech have also been reported.Lip enhancement complications (e.g. postoperative infection or overfilling with fillers) and trauma-related scar formation are additional indications for lip reduction surgery.Dentofacial abnormalities resulting in pseudo-macrocheilia has to be recognised before any irreversible damage is done. Acute inflammation and psychiatric instability are contraindications for lip reduction surgery. Management: Principles of surgical correction are to correct any underlying dento-osseous deformities and establish a balance between upper and lower lip tailored to the individual patient.We present a case of a 26-year-old Asian male with hypertrophic upper and lower lip who requested lip reduction surgery purely for aesthetic reasons.Oral and maxillofacial surgeons should be aware that "cheiloplasty" is a simple procedure, which is reliable and has predictable results when surgical principles are adhered to and contraindications are kept in mind.