Lip lift

A lip lift is an operation that shortens the distance between the nose and upper lip. While shortening this distance, we aim to increase the visibility of the red portion of the upper lip and of the upper teeth during speech or smiling. Describing the detail you would like to change helps us understand your expectations before beginning measurements and markings.

Upper lip and philtrum anatomy

The upper lip consists of the externally visible skin portion and the red lip portion, called the vermilion. The philtrum is defined by the central groove and surrounding ridges extending from the nasal base to the upper lip border. The curved border in the center of the red lip is called Cupid’s bow.

The height of skin between the nasal base and red lip border, the visible height of the red lip, and the lip’s forward fullness are separate features. In someone with a long skin portion, the red lip may appear turned inward. A lip lift plan uses this anatomical distinction to describe which feature is to be changed.

The muscle tissue surrounding the mouth contributes to lip closure and movement. The upper lip’s position at rest therefore differs from its position during speech and smiling. Upper tooth visibility also relates to lip length, muscle movement, and upper jaw structure.

Who may be a candidate?

The length of the distance between the nose and upper lip and the thinness of the upper lip are features we focus on in lip lift consultations. When you share the change you would like to see, we assess the visibility of the red portion and the nose-to-lip distance within the same plan.

Further shortening may not be appropriate for people whose skin distance between the nose and lip is already short. If tooth visibility is pronounced at rest or a broad area of gum shows when smiling, the relationship between lip position and the upper jaw is examined separately. Whether thinness relates to tissue volume or inward turning of the lip also informs suitability.

The position and length of the upper teeth and the gumline affect the area visible when smiling. An appearance related to upper jaw structure or tooth alignment may require a dental assessment. A lip lift does not change tooth position or the position of the upper jawbone.

Active infection around the lips or an uncontrolled illness affects the decision about surgery. Previous lip fillers and surgical procedures are also considered when interpreting the existing shape. Skin length, lip volume, and mouth corner position are assessed together with this information.

Lip lift and fillers

Lip fillers shape lip contours and fullness by adding volume to the tissue. Fillers do not shorten the length of skin between the nose and upper lip.

We can also add lip augmentation procedures to lip lift surgery.

In a lip lift beneath the nose, skin removal changes the position of the upper lip. The change in red lip visibility relates to moving existing tissue upward and turning it outward. This procedure does not place a volume-adding substance inside the lip.

A person may have both a long nose-to-lip distance and low red lip volume. In this situation, shortening the distance and adjusting volume are defined as separate goals. Including a lip lift and augmentation in the same plan depends on identifying both needs during the examination.

A thin-looking red lip relates to how far the tissue turns outward as well as its volume. Even when there is enough tissue in the upper lip, the visible height of the red portion may be low. Skin length, red lip height, and lip projection in profile are recorded separately during the examination to determine whether the desired change relates to volume or position.

The shape considered for the upper lip relates to lower lip height and mouth width. Raising the central red border and changing the width between the mouth corners are different surgical goals. Markings may therefore differ for someone seeking fullness in the center of the lips and someone wanting to change visibility at the sides.

If lip fillers have been used before, this information helps interpret the visible red portion and fullness in profile. Because volume inside the lip and skin length beneath the nose are different features, the site of previous treatment is clarified during the examination. Treatment records can be shared if available. The desired lip lift change is defined again in relation to the current lip shape.

Lip lift techniques also differ in how much they involve the central lip or the portions extending toward the sides. Central markings focus on the appearance around Cupid’s bow, while markings extending toward the sides of the nasal base cover a different area of skin. Nasal base width and the shape of the red lip border are considered together when choosing a technique. The markings can show how a named method would apply to your lip.

Philtrum measurements and tooth visibility

Before surgery, we measure the distance between the nose and upper lip in detail and mark the tissue to be removed. Using these markings, we can discuss which portion of the lip will move upward. Showing the change you would like on your lip helps us relate the measurements to your expectations.

The examination compares the position of the lips at rest with their shape during smiling. Upper tooth visibility is assessed in both positions.

When assessing philtrum length, the length of skin between the midpoint of the nasal base and the red border of the upper lip is measured. The length of the central section may differ from the height of the sides. Markings take into account the midline, the bases of the nasal wings, and the right and left positions of the upper lip border.

Upper incisor visibility is recorded with the lips resting without strain. During smiling, the amount of lip elevation and the appearance of the gumline are examined. These measurements may change in a pose with the lips stretched. Recording the resting appearance and smile separately provides different information about lip length and movement.

The lip plan also includes lower lip position, chin height, and the shape of the nasal base. A single measurement of the nose-to-lip distance does not determine the same surgical plan for every face. The same skin length can mean different things in people with different red lip heights and tooth visibility.

Subnasal lip lift and the incision

We can perform a lip lift on its own under local anesthesia, numbing only the treatment area. We can also perform it under general anesthesia, with you asleep, together with other operations such as rhinoplasty.

We make the incision beneath the nose. We shorten the nose-to-lip distance by removing the tissue identified through measurements and markings. We then close the area with fine cosmetic sutures. We complete the procedure with a check and dressing.

A lip lift beneath the nose is also called a subnasal lip lift. Bullhorn describes the shape of the incision markings that follow the nasal base and the folds beneath the nasal wings. In this approach, a strip of skin next to the nasal base is removed, and the lip skin below it is moved upward to close the incision.

The middle of the incision lies beneath the columella, the structure between the nostrils. Its sides may extend to the bases of the nasal wings. The width of the markings and the skin to be removed vary according to how much shortening is needed in the center and sides of the lip. Right-to-left differences in the nasal base are also considered in placing the markings.

In the approach called a direct lip lift, the incision is planned along the boundary between the red upper lip and the skin. Removing skin from this area changes the position of the lip border. The subnasal approach follows the nasal base, while the direct approach follows the lip border. When researching technique names, looking at where the incision is placed helps clarify which tissue is moved.

A front view shows the lip border and differences in height between the right and left sides, while a profile view shows upper lip projection. The slope of the upper lip skin and the outward turn of the red portion form different lines in the same photograph. If the nasal tip points downward, the visual impression of the nose-to-lip interval may also change. Lip length is therefore not interpreted solely from the extent of the red area visible from the front.

Corner lip lift

A corner lip lift describes surgical adjustment of downward-pointing mouth corners. Incisions are planned around the mouth corners, near the boundary between skin and lip. A subnasal lip lift addresses the distance between the upper lip and nose, while the corner approach addresses the position of the sides of the mouth.

The direction of the mouth corner relates to the structure of the junction between the upper and lower lips and the surrounding soft tissues. Lines extending from the mouth corner toward the chin and the position of the corner itself are separate features. Distinguishing these during the examination helps determine whether a subnasal approach or a corner procedure relates to the desired change.

Differences in height between the right and left halves of the upper lip may relate to the shape of the red border or the position of the mouth corners. Differences in the nasal base may also make upper lip length appear different on either side. Examining these structures separately before marking helps describe which area the procedure will address.

Planning together with rhinoplasty

When rhinoplasty and a lip lift are planned together, tip orientation, columella position, and upper lip length are examined in the same profile view. The angle between the nose and upper lip is a separate measurement from lip skin length. A change to the tip and a change to the lip distance are therefore described separately.

A surgical plan for other parts of the face does not mean that upper lip skin length will also change. If a lip lift is being considered, a separate plan is made for philtrum length and tooth visibility. Incisions at the nasal base and mouth corners are marked separately according to the area each procedure targets.