Melkersson-Rosenthal syndrome is a rare condition which consists of progressive and recurrent orofacial edema, intermittent facial palsy, and lingua plicata. Labial swelling is the most common feature of this syndrome complex. The lips may enlarge up to three times their normal size, resulting in aesthetic deformity and functional disability. Traditional medical interventions are only marginally successful in treating this syndrome. We present a case of Melkersson-Rosenthal syndrome with massive lower lip enlargement, which was successfully treated by combining a fleur-de-lis resection with a transmodiolar labial suspension suture. Five-year follow-up photographs are presented.