Ascher syndrome is a rare, benign disorder typically identified by the triad of blepharochalasis, double upper lip, and occasionally non-toxic thyroid enlargement. Due to the variable presence and often isolated manifestation of its components, the diagnosis may be delayed or overlooked. In this report, we describe the case of a 31-year-old woman with a prominent double upper lip and bilateral upper eyelid laxity, the latter developing over years as a result of recurrent painless eyelid edema beginning in childhood. Clinical evaluation confirmed characteristic blepharochalasis and mucosal redundancy of the upper lip, with normal thyroid function and ultrasonographic findings limited to small asymptomatic nodules. Histopathologic examination of the excised eyelid tissue demonstrated hyalinized, acellular fibrous nodulation without neoplastic features, consistent with chronic post-edematous changes. The patient underwent successful upper eyelid blepharoplasty, achieving a favorable cosmetic result. This case emphasizes the importance of recognizing the constellation of findings suggestive of Ascher syndrome, even in the absence of overt thyroid involvement. Awareness of this rare condition allows for timely diagnosis and appropriate surgical planning, which are crucial for optimizing both functional and aesthetic outcomes.

Double lip is an unusual clinical finding, considered to be a developmental anomaly, and usually involving the upper lip more frequently than the lower lip. It may be seen in isolation or in association with Ascher's syndrome. It is caused by excessive areolar tissue and noninflammatory labial mucosa gland hyperplasia of pars villosa. During smiling, the lip is retracted, and the mucosa is positioned over the maxillary teeth, resulting in "cupid's bow" appearance. The incidence of this anomaly is not known. It has been reported in cleft patients, following lip trauma, and as a consequence of lip-biting habits. It might pose esthetic or functional problems and may be a reason for psychological stress to the affected individual because of over shown hyperplastic lip tissue. Surgical treatment is indicated for the correction of this disfigurement. Various surgical techniques have been suggested to address the double upper lip anomaly. All of these involve the excision of excessive mucosa and the underlying tissue. This case series puts forward the surgical management of this rare anomaly in a relatively simple manner. Double lip is a subject of interest to the dental clinicians because they usually are the first professionals to detect, identify, and treat this uncommon condition.