Q: Lip lift surgery pros and cons

Pros This relatively quick facial plastic surgery procedure is performed under local anesthesia. It’s a long-lasting solution for creating fuller, more youthful-looking lips, without the ongoing maintenance of temporary lip fillers . It can reduce signs of perioral aging, make your mouth look more proportional to the rest of your face, enhance your lip shape, and expose more of your upper teeth. Because it simply lifts tissue, rather than adding volume, there’s no danger of looking over-filled. Cons If the surgeon removes too much skin, it’s very challenging to restore that length. It will show off more of your top teeth, so if your upper teeth are crowded, discolored, or uneven, you might want to either consider other lip augmentation options like fillers—or spring for teeth straightening and whitening . You will be left with a small scar. “There’s always scarring at the base of the nose. But [if the lip lift is] performed well, with meticulous closure, there is just a very fine line scar that forms. It can further be improved with laser resurfacing,” says Dr. Gary Linkov , a double board-certified facial plastic surgeon in New York City. An overdone lip lift can affect the mechanics of the mouth, interfering with speech, whistling, and kissing.

Q: What are the different types of upper lip lifts?

There are a few different approaches to an upper lip lift. The bullhorn lip lift or subnasal lip lift is the most common technique. It involves removing the skin just below and to the sides of the nostrils. The scar is hidden under the base of the nose. For an Italian lip lift , the surgeon removes two small pieces of skin from under the nostrils. It usually doesn't leave much of a scar, but can distort the nostril base. A gullwing lip lift includes one incision at the junction of the vermillion and skin of the upper lip. Dr. Rodriguez says that this procedure has fallen out of favor because it destroys the roll of tissue between the lip skin and the vermillion. It also gives the lip a flattened look. A corner lip lift addresses the oral commissure, or the corners of the mouth where the upper and lower lip meet. By removing a triangular wedge of tissue from each side, the procedure can correct a downturned mouth while also exposing more of the vermillion at the corners (where lips tend to disappear with age), for a fuller, more symmetrical appearance. A corner lip lift is commonly done in conjunction with a bullhorn lip lift. Related: The Ultimate Guide to Fuller Lips—From Plumping Glosses to Silicone Implants

Question 1

What is a lip lift?

Accepted Answer

A lip lift is an in-office surgical procedure that removes a small strip of skin under the nose to shorten the philtrum between the base of the nose and the top lip. The benefits of a lip lift include:

exposing more of the vermilion—the darker-colored part of the lips—by slightly rolling up its border
shortening a top lip that has elongated with age
revealing more of your upper teeth, for greater “tooth show”
defining and contouring the Cupid’s bow, for a fuller, more youthful appearance

Some patients opt for a corner lip lift, which raises the corners of the mouth by removing a small amount of skin, or skin plus muscle, at the corners of the mouth.

This highly customizable outpatient procedure can be performed under local anesthesia. It usually takes about an hour and leaves a discreet scar. It’s commonly done as an add-on to a facelift.

“The procedure has a big impact for several reasons,” explains Dr. Ricardo Rodriguez, a board-certified plastic surgeon who performs both upper and corner lip lifts at his practice in Baltimore, Maryland. “When people look at faces, they focus mostly on the eyes and the mouth, so the lips have a very important role in how others perceive you. Secondly, we all recognize the appearance of the lips as a marker for aging. Finally, the relation of the upper lip to the nose determines the relationship and harmony between the lower and middle thirds of your face, so the length of your upper lip plays a big role in facial proportions.”

Lower lip lift procedures, commonly called lower lip advancement, are less common. They’re performed on patients who have an especially thin lower lip or oversized upper lip, to make them look more proportionate.

Question 2

Lip lift surgery pros and cons

Accepted Answer

Pros

This relatively quick facial plastic surgery procedure is performed under local anesthesia.
It’s a long-lasting solution for creating fuller, more youthful-looking lips, without the ongoing maintenance of temporary lip fillers.
It can reduce signs of perioral aging, make your mouth look more proportional to the rest of your face, enhance your lip shape, and expose more of your upper teeth.
Because it simply lifts tissue, rather than adding volume, there’s no danger of looking over-filled.

Cons

If the surgeon removes too much skin, it’s very challenging to restore that length.
It will show off more of your top teeth, so if your upper teeth are crowded, discolored, or uneven, you might want to either consider other lip augmentation options like fillers—or spring for teeth straightening and whitening.
You will be left with a small scar. “There’s always scarring at the base of the nose. But [if the lip lift is] performed well, with meticulous closure, there is just a very fine line scar that forms. It can further be improved with laser resurfacing,” says Dr. Gary Linkov, a double board-certified facial plastic surgeon in New York City.
An overdone lip lift can affect the mechanics of the mouth, interfering with speech, whistling, and kissing.

Question 3

How much is a lip lift?

Accepted Answer

The price you pay for this cosmetic surgery will depend on your provider’s credentials, level of experience, and practice location, as well as the details of your procedure.

Cosmetic procedures like this one aren’t covered by insurance, but most surgeons offer payment plans or accept financing options like CareCredit.

See our complete guide to lip lift costs

Question 4

Lip lift before and after pictures

Accepted Answer

The lip lift photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

Who makes a good candidate?

Accepted Answer

Good candidates for an upper lip lift have at least 10 mm (and, ideally, 12 mm or more) between the base of the nose and the upper lip.

Patients choose the procedure for several reasons. “I have been doing the lip lift for over 20 years, and there is no typical patient,” says Dr. Rodriguez. “Every patient has their own needs, and it is important to get a clear understanding of not only the length the patient wants, but the shape. Some patients want a pronounced Cupid’s bow, others not.”

These are some of the most common motivations.

Shortening a long lip. Some people naturally have a longer than average midface and an especially long top lip. However, Dr. Rodriguez cautions that “with these patients one must be very careful, as a poorly planned lip lift may result in too much tooth show.”
Reducing signs of aging. The skin between the bottom of the nose and top of the upper lip stretches with age, which can make the mouth look smaller and lower.
Avoiding lip fillers. Dr. Rodriguez commonly sees both older and younger patients who have tried lip fillers and weren’t happy with the result. “Fillers lengthen the lip and create an abnormal pout, making the patient look more critically at their lips and become aware of length issues,” he says. In contrast, a lip lift permanently enhances naturally thin lips or those that have thinned with age. “The combination of shortening length, increasing vermillion show, and increasing tooth show has a huge impact that surpasses anything possible with fillers.”
Increasing tooth show. Exposing more of the upper teeth can make patients look younger.
Feminizing the face. Dr. Rodriguez says that the procedure “can have a profoundly feminizing effect on facial appearance,” so it’s increasingly being performed as a gender-affirming procedure.

Question 6

What are the different types of upper lip lifts?

Accepted Answer

There are a few different approaches to an upper lip lift.

The bullhorn lip lift or subnasal lip lift is the most common technique. It involves removing the skin just below and to the sides of the nostrils. The scar is hidden under the base of the nose.
For an Italian lip lift, the surgeon removes two small pieces of skin from under the nostrils. It usually doesn't leave much of a scar, but can distort the nostril base.
A gullwing lip lift includes one incision at the junction of the vermillion and skin of the upper lip. Dr. Rodriguez says that this procedure has fallen out of favor because it destroys the roll of tissue between the lip skin and the vermillion. It also gives the lip a flattened look.
A corner lip lift addresses the oral commissure, or the corners of the mouth where the upper and lower lip meet. By removing a triangular wedge of tissue from each side, the procedure can correct a downturned mouth while also exposing more of the vermillion at the corners (where lips tend to disappear with age), for a fuller, more symmetrical appearance. A corner lip lift is commonly done in conjunction with a bullhorn lip lift.

Related: The Ultimate Guide to Fuller Lips—From Plumping Glosses to Silicone Implants

Question 7

What happens during lip lift surgery?

Accepted Answer

Lidocaine will be injected to numb the area, so you should feel no pain during the procedure. IV or oral sedation is also an option. Once you’re numb and relaxed, the entire procedure will take about an hour.

Here’s what typically happens during a surgical lip lift:

To perform a bullhorn lip lift, your provider will draw a wavy ellipsis shape, resembling bullhorns (or angel wings) right under your nostrils, outlining where they plan to cut and remove skin. The larger the piece removed, the greater your lift will be.
Your surgeon will cut along the outline and remove the bullhorn. Many surgeons address the muscle layer along with the skin, to get a more durable lift and minimize scarring.
After excision, they’ll use tiny sutures or surgical glue to anchor the remaining skin at the base of the nose, suspending your top lip and instantly shortening the philtrum.
Some surgeons anchor the skin to deeper structures in areas like the septum of the nose and the internal nasal membranes, to get a tension-free closure. “Tension at the wound can cause nasal distortion or thick scars,” cautions Dr. Rodriguez.

The ideal philtrum length is considered 10–12 mm, but your doctor may decide not to go that short. “For example, if the philtrum starts at 20-plus mm, reducing it down to 10 mm, or even 12 mm, is a major distortion to the facial features,” says Dr. Linkov. “So for someone with a length of 20-plus mm, I will frequently bring them down to about 14–15 mm.”

Question 8

How long does lip lift recovery take?

Accepted Answer

Most people return to work after about 1 week of downtime. Here’s what you can expect during your recovery:

The incision will be swollen for a week to 10 days post-op.
You might have some bruising around your mouth.
Your doctor will likely advise you to apply cold compresses, take over-the-counter pain medications as necessary, clean the incision with diluted hydrogen peroxide, and apply an antibiotic ointment twice daily for 1 week.
You’ll need to refrain from smoking, smiling, and wearing makeup for at least 2 weeks.
If your surgeon didn’t use dissolvable sutures, they’ll need to be removed 1 week after your procedure.
If they applied surgical glue, it’s best to let it peel away on its own; try to avoid picking at it or attempting to remove it yourself, which can make the scar more noticeable.
The worst of the swelling should be resolved within 2 weeks.
Scar tissue takes time to fade and flatten, but it will get smoother over time. Some patients will need steroid injections during recovery to ensure good healing. Your provider may also recommend silicone sheets or gel to reduce the scar’s appearance. You can also cover any redness with makeup.
If you notice a change in sensation near your scar, talk to your doctor. Several RealSelf members say they lost feeling in their lips or had trouble speaking. This should be temporary, but it could take a few months to fully resolve.
You’ll see your final results once all the swelling, bruising, and scarring settle down—usually in about 3 months.

Question 9

How long does a lip lift last?

Accepted Answer

Lip lift results can last for over 10 years. Your lips will continue to age along with the rest of your face, but they’ll always look more youthful than if you hadn’t had the procedure.

If you lose volume over time, that can be remedied with lip fillers or a more long-lasting solution, such as fat transfer or lip implants.

Question 10

What causes a fallen lip lift?

Accepted Answer

According to Dr. Rodriguez, poor surgical technique can result in a fallen lip lift. “The upper lip may elongate 1-2mm over a long period of time, but most elongation in a short timeframe, or elongation greater than 2mm, is due to a lack or failure of proper fixation of the upper lip to a stable base,” explains Dr. Rodriguez.

“The skin of the columella and nostrils is mobile, and the skin of the lip adheres to the muscle of the lip. The constant action of the lip creates constant tension on the base of the nose," he explains. "This can drag down the columella and nostrils, making the lip appear longer.”

This increased tension can also change the shape of your nose. “That is why some patients complain that their nose got longer or the tip turned up after a lip lift,” says Dr. Rodriguez.

Question 11

What are the risks of a lip lift?

Accepted Answer

The risks of a lip lift include bleeding, infection, poor scarring, numbness, changes to the base of the nose, an unsatisfactory result, speech issues, and asymmetry.

This procedure can yield a perfect result, “or it can be a disaster, depending on how it is performed,” according to Dr. Brent Moelleken, a board-certified plastic surgeon in Beverly Hills, California.

Most complications are due to a lack of proper fixation during surgery.

“When the upper lip is not fixed to a stable base, the tension of the highly mobile lip will manifest in several ways,” according to Dr. Rodriguez.

The pull of the lip muscle can cause nostril or nasal tip distortion.
The scar can migrate down and become more visible.
The tension can also create a raised hypertrophic scar, as “the body tries to prevent the skin edges from pulling apart by depositing extra collagen for added strength.”

“If the patient requests an aggressive lift, has a long midface, or already has good tooth show before surgery, the possibility of a gummy smile should also be considered,” says Dr. Rodriguez.

Look for an experienced, board-certified plastic surgeon who can assess whether you have the right lip-to-nose ratio to achieve your desired results.

RealSelf Tip: There have been some safety concerns around combining a lip lift with open rhinoplasty because of the proximity of the incisions in the columella. Since only a small island of skin is left between the two procedure incisions, skin necrosis (tissue death) or excessive scarring is possible. If you are considering combining these procedures, make sure you discuss these risks with your doctor.

Question 12

Which alternatives are worth considering?

Accepted Answer

You may also want to consider one of these lip augmentation or rejuvenation procedures, keeping in mind that none of them shortens or lifts the lip.

A Botox lip flip: If you’re interested in a more subtle result without the expense, risks, or recovery time involved with surgery, a Botox lip flip can be a good option. An experienced injector can use microdoses of Botox, which relaxes the muscles in the upper lip, making the vermillion appear larger and more pouty. Results last up to three months.
Lip fillers: Hyaluronic acid fillers, such as Juvéderm and Restylane, can instantly make lips look fuller and refine their shape. Results last 4 to 12 months, depending on the type of filler used and your own metabolism.

Related: Botox Lip Flips vs. Filler: Which Option Is Better?

LIP LIFT

BEFORE & AFTER PHOTOS

Ricardo L. Rodriguez, MD

Mari Malcolm

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	Botox nonsurgical	Lip Fillers nonsurgical	Facial Fat Transfer surgical	Lip Implants surgical
Worth It Rating	97%	95%	89%	80%
Average Cost	$590	$660	$7037	$2900
Downtime	No downtime	No downtime	1 week of downtime	Up to 3 days of downtime
Anesthesia	No anesthesia	Topical numbing cream	Local anesthesia	Local anesthesia

BEFORE & AFTER PHOTOS

Ricardo L. Rodriguez, MD

Mari Malcolm

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