I don't know there wasn't much detail given. It could just be that Mr. Manners didn't want to have to look at
her strangely puffy lips.
But the only reason I know this is that someone once asked Roger Ebert the question for his Movie Answers Man column and he referred it to her for her opinion. I think it was Miss Manners anyway, I assume all those ettiquette columns are written by just one person as there can't really be more than that many who care.