A decade ago, the lip lift was a little-known procedure—something plastic surgeons quietly tacked on to facelifts, for the sake of facial harmony. Shortening a long upper lip can give the mouth a more youthful vibe, better syncing it with the revised proportions of a freshly lifted face. “Then, seven or eight years ago, the script flipped, and younger patients started getting lip lifts,” says Dr. Miguel Mascaró, a board-certified facial plastic surgeon in Delray Beach, Florida.
Over time, as patients warmed to the idea of the procedure—which removes a bullhorn-shaped strip of skin from the base of the nose, to subtly hike the center of the top lift—variations on the conventional lip lift began to emerge, including the now buzzy corner lip lift. “Interest is definitely growing,” says Dr. Mascaró, who averages three to five corner lifts a week, on patients of all stripes. “You get the younger ones who want that smirk, that voluptuous, exotic look,” he adds. “And then you have the older patients, who actually need their corners addressed because they have a functional issue,” which gives the mouth an unhappy, downturned appearance.
What’s the goal of a corner lip lift?
The corner lip lift can take many forms—specialists tend to put their own spin on it, offering signature techniques—but generally speaking, the operation takes aim at the corners of the mouth, or what doctors call the commissure, where the upper and lower lips come together. Depending on the incision location and design, the procedure can simply unbury the outer edges of the top lip—to reveal more red, for a more uniform vermillion border—and/or it can improve the disposition of the mouth, “changing a sad face to neutral or happy,” explains Dr. Ben Talei, a board-certified facial plastic surgeon in Beverly Hills, California.
Who’s a good candidate for a corner lip lift?
“Most patients who wind up getting a corner lip lift don’t initially know what they’re looking for,” Dr. Talei tells us. “Younger people commonly complain of difficulty exposing or lifting the lateral [or outer] lip with fillers. They keep filling and filling—but that part of the lip doesn’t respond well to fillers.” This strip of upper lip near the corners “lacks support and is much more challenging to treat with fillers,” Dr. Talei adds. Folks with this hidden lateral lip are often good candidates for some version of a corner lip lift, as it “can be used to gain increased exposure and balance across the entire [upper] lip,” he says.
Due to its unique anatomy, Dr. Talei notes, “the lateral lip also ages more rapidly than the central lip”—hence its tendency to droop. But not every frown results from aging. “Some younger patients also have a slight commissure downturn—and that’s a function of genetics,” says Dr. Mascaró. There’s a highly complex intersection of muscles at the corners of the mouth, where the depressor (or pull-down) muscles meet—and often overpower—the levator (or lifting) muscles in the area.
While people of all ages with downturned mouths can benefit from a corner lip lift, some may require additional treatments if forces like volume loss, overactive muscles, or widespread facial sagging are contributing to sunken, sagging corners. For instance, when someone gets a corner lip lift specifically to flip their frown, Dr. Talei advises them to book routine Botox injections post-op, “to prevent down-pull of the area during healing or in the future,” he says.
The corner lip lift is frequently done in conjunction with a traditional bullhorn lip lift, but each type of lip lift can be a stand-alone procedure. “In my practice, I always do a [standard] lip lift first and reserve the corner lift for only those patients who heal well at the subnasal area and could still benefit from the corner lift,” says Dr. Gary Linkov, a board-certified facial plastic surgeon in New York City. “Because as much as patients are concerned about the corners before a lip lift, they often are quite content with the results of the [central] lip lift alone—and this way, we avoid those additional scars along the lateral vermillion border.”
Everything depends on an individual’s anatomy and concerns, of course. “The way I see it,” adds Dr. Mascaró, “sometimes the corners are the cherry on top, and other times, they’re the main course.” Particularly for older patients with melancholy expressions, “the corner lip lift is really the main course,” he notes.
What kind of scar does a corner lip lift leave?
This depends on the surgeon’s approach, which they tailor to your specific issues and goals. The most straightforward version of the procedure (sometimes called a medialized corner lip lift or lateral vermillion advancement) aims to unfurl the outer edges of the lips by removing a triangular wedge of skin from just above the upper lateral lip. It leaves a short scar along the vermillion border.
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When there’s an element of drooping at the corners, surgeons use a more involved technique to address the angle of the mouth directly. In such cases, incisions may extend beyond the commissure into the cheek (aptly called an extended corner lift) or they can wrap around the corners, taking the shape of less-than and greater-than symbols. The wraparound technique essentially “hides the scar around the lower lip—but not everyone is a good candidate, and there are limitations with how much elevation we can get with it,” Dr. Mascaró says.
With the extended corner lip lift, carrying the scar toward the cheek may seem scary, but Dr. Mascaró finds that with his suturing and design pattern, scarring is minimal and rather predictable. “I can anchor it pretty well and get a pencil-thin line that looks like a tiny wrinkle extending out the side,” he says, which blends in fairly well, especially on an older face.
With the wraparound technique, the muscles near the commissure, which are manipulated during surgery, can sometimes respond in an unwanted way, causing a slight divot to form at the corners of the mouth. While easily fixable, it is an added worry with this technique, says Dr. Mascaró—particularly for older folks.
Which corner lip lift technique is right for you?
Dr. Mascaró employs a rather complicated algorithm to determine which approach will work best for a given patient and says there are pros and cons to each. One consideration, which pertains primarily to more mature patients, is whether their downturned corners are punctuated by a heavy crease of fold. “For that, you need to do an extended corner lift,” he says; the wraparound can’t correct it.
A word of caution about the extended corner lip lift: it can add width to the mouth. And the more lift you shoot for, the wider the mouth is going to get, Dr. Mascaró says. For this reason, not every surgeon offers this version of the corner lip lift. “I don’t like to extend the incision laterally beyond the oral commissure, because the scar can give a Joker’s smile appearance,” Dr. Linkov notes. “I prefer to extend down along the commissure if needed.”
With any corner lip lift, scars are inevitable—and their prominence can vary. “Hypertrophic scarring [a thicker, raised scar] may occur temporarily or permanently and should be treated with 5-Fluorouracil [5-FU] injections,” explains Dr. Talei. “This is an off-label use of 5-FU, but it is a very effective medication with a lower side-effect profile than [the steroid] Kenalog in these areas.” CO2 laser treatments can also help shrink or smooth scars. “Most patients don’t need any treatment at all, but interventions may be necessary,” he says. The good news: if treated early and properly, scars should become barely visible.
What are the risks of corner lip lift surgery?
Beyond scarring, the risks include bleeding, infection, asymmetry, overcorrection, undercorrection, and perhaps most worrisome, “labial incompetence”—the inability to fully seal the lips without straining. While this is a rare complication, “it certainly can happen, because we’re playing with the corners of the mouth, releasing and reattaching them,” Dr. Mascaró says. “It’s a very complicated area, with a lot of moving parts, and we have to be very delicate—and oftentimes, we have to err on the side of conservative.”
Can injectables help lift the corners of the mouth?
Yes—though the result is temporary and less dramatic than what you’d see with surgery. That said, “Botox to the DAO [or depressor anguli oris muscle, which tugs down the corner of the mouth] works really well,” according to Dr. Mascaró. He likens the treatment to more of a dimmer than an on/off switch, explaining that “you slowly see an improvement, and then you slowly see [the corners] come back down.” Since tiny doses, on the order of 2.5 units per side, are typically injected, the effect of DAO toxin may last only a couple of months.
Injecting a small amount of a soft hyaluronic acid filler along the commissure can further lend support, particularly in those with sunken corners, but too much can be counterproductive, dragging the mouth down even more. Done right though, this nonsurgical pairing can offer a couple millimeters of lift, Dr. Mascaró says, and has been shown to have a high patient-satisfaction rate. (For comparison, a surgical corner lip lift can usually deliver about five to seven millimeters of lip elevation in the right patient.) Just be aware, the perks of filler and toxin apply mainly to those desiring a true upturn at the corners of the mouth. If you’re hoping to evert the edges of the top lip, for a fuller look, injectables will likely leave you disappointed.
