There are 2 operations that can be done depending on how much unaffected skin there is .If there is plenty of healthy skin(at least 6 mm) then a lip reduction can be done where the affected area is cut out. If there is not enough healthy skin then vermilionectomy can be done (also called lip shave with mucosal advancement) .The affected area is cut out and the mucosa from inside the mouth is advanced out to replace it. The skin adapts over about three months to the new enviorment. It will be dry for that time and should not be done if there is any chance of biting or peeling off the new skin. You can read about the procedure if you do a google book search for Atlas of Head and Neck Surgery By Byron Bailey page 43. The surgery is fairly common for people with actinic cheilitis and according to my doctor ,has good results. However it is a last resort and only after all other treatments have failed.He reccomended protopic .1% for at least 3 months first.If that does not work then he reccomends some barrier cream.He also prescribed plaquenil for 3 months.It is originally an anti malaria drug but is used to reduce skin inflammation. The doctor co- authored the book Dermatology of the Lip and sees only patients oral skin problems.