Lip lift candidacy and ensuring successful, natural, outcome? (Photos)

Question

My philtrum (nasal sill - highest pt of cupid’s bow ~18-19 mm) seems to elongate, defeminize, and age my face. Am I am an appropriate candidate for a lip lift? I am unsure d/t e.g. the prominence/angle of my nasal spine region, etc. If I am an appropriate candidate, how can I best ensure that I would have a natural-looking outcome and that my surgeon adheres to my specified goals for a more modest length improvement? What specific questions and agreement details might I consider?

Anna Chacon, MD, FAAD · Answer

Thank you for your detailed question and for sharing photos—they are quite helpful in assessing proportions.

Based on your description and the images, it does appear that the philtrum length (18–19 mm) is on the longer side for a youthful, feminine aesthetic. A well-executed subnasal lip lift can subtly shorten this distance and enhance overall balance, but careful planning is essential.

Here are a few considerations:

Candidacy:
You seem like a possible candidate, especially since your upper lip has a relatively modest volume and your philtrum elongation is not due to overfilling or swelling. The presence of a prominent nasal spine isn't an absolute contraindication but may influence how the incision is designed and how much tissue can be safely removed.

Natural Outcome Tips:

Opt for a conservative reduction (typically 3–5 mm max). Too much shortening can create an unnatural, “pulled” look.

Request that the incision remain within the natural curvature of the base of the nose (the alar sill) to avoid visible scarring.

Make sure the surgeon preserves the natural curvature and tubercles of the upper lip rather than flattening them.

Questions to Ask Your Surgeon:

“How much will you plan to shorten the philtrum, and how do you determine this?”

“Will you maintain the natural contour of my Cupid’s bow and lip roll?”

“Can I review before-and-after photos of patients with similar anatomy and goals?”

“How do you approach tension management in closure to avoid a widened or visible scar?”

“What is your plan if I want a very subtle change?”

Pre-op Agreement Details to Consider:

Clear documentation of your aesthetic goals (a “modest” correction).

Agreement on a maximum amount of philtrum shortening.

Review of anatomical challenges, such as nasal projection and spine angle to tailor the plan.

If you're still unsure, a 3D morph simulation or trial using temporary upper lip volumization (like a modest HA filler) could help preview balance before committing to surgery.

Jacob Tower, MD · Answer

Hello, hope you are well. Based on the photos that you have submitted, you do appear to be an appropriate candidate for a lip lift. Your upper lip is disproportionately elongated (compare with lower lip); a well-concealed subnasal incision could be made to shorten the philtrum. I believe the best was to gain confidence in your potential outcome and surgeon is to view before-and-after photos and read reviews. Good luck!

Best,
Dr. Tower

Gary M. Horndeski, MD · Answer

A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.  It takes about 1 hour to perform under local anesthesia and costs $3,000.  You may also want to consider a chin implant.

Best Wishes,

Gary Horndeski, M.D.

Piotr Osuch, MD · Answer

I wouldn't recommend lip lift in your case. Although your philtrum length seems to be reasonable from the point of view of a lip lift, you already have good teeth show. After a lip lift you may end up with even more visibile teeth ("rabbit look"). If you are interested in more prominent lips, I'd suggest lip fillers or lip flip+ fillers by an experienced aesthetic medicine doctor.
best regards Piotr Osuch, MD, PhD

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