Is there such a thing as a scarless (or not widening) corner lip lift? (Photo)

Thank you for your question and for sharing the photo, which helps guide the assessment.

1. Scarless or Minimal-Scar Corner Lip Lift – Is It Possible?
While no surgical procedure is truly scarless, a well-executed corner lip lift can result in subtle, nearly imperceptible scarring, especially when performed with precise technique and in patients with favorable healing tendencies. However, it’s important to understand that corner lip lifts inherently carry a risk of visible scarring since they are performed in a highly expressive and mobile area of the face.

The concern about "widening the mouth" or creating an unnatural horizontal pull often depends on where the incision is placed and how much lateral extension is made. A targeted lift directly above the oral commissure, rather than extending outward, may yield subtler changes and avoid an exaggerated look—but this also limits how much lift can be achieved.

2. Non-Surgical Alternatives – What Can Help?
You mentioned that you’ve tried Botox without success, which is not uncommon. Botox around the corners of the mouth can help in cases where muscle pull (particularly the depressor anguli oris) is a contributing factor—but it does little for true volume deficiency or skin laxity.

Regarding Ellacor (micro-coring technology), while it's promising for skin tightening and mild lifting, its effect in such a localized and dynamic area like the oral commissure is limited. It’s not designed to create directional lifting the way a surgical procedure would. Using it directly above the corner of the mouth may improve skin texture slightly but would not replicate the structural lift a surgical approach offers.

3. Conservative Surgical Revision – An Option?
If you remain open to a surgical solution, a precisely placed, conservative corner lift done directly above the existing commissure—with minimal lateral extension—can improve the downturned appearance without significantly widening the mouth. This approach can be tailored to focus more on elevation rather than extension, especially if done by a surgeon familiar with nuanced lip dynamics.

4. Additional Considerations:

Scar care: If a future procedure is considered, strict post-op scar management (e.g., silicone gel, laser resurfacing, microneedling) can significantly reduce scar visibility.

Filler support: In some cases, subtle hyaluronic acid filler placement near the oral commissures can help lift or reshape corners in a non-surgical way—especially if scar tissue is minimal but contour is an issue.

In Summary:
While a completely scarless corner lip lift doesn’t exist, there are refined surgical techniques that minimize scarring and avoid excessive widening. Ellacor may have some minor benefit for texture, but it will not provide the targeted lift you're looking for. A direct, minimal approach above the commissure, possibly combined with good scar management, may offer the best balance of aesthetic improvement and scar control.

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

What you need is a lip lift where tissue is taken out laterally not centrally. The trouble with a central lip lift is that it only pulls up the center and the corners will appear downturned. You will need this revision.

Best Wishes,

Gary Horndeski, M.D.

I did two of these yesterday! There is always a scar with any surgery. However, we should truly be able to make a scar that is very hard to see and gives you the improvement you want. I did three ellacors yesterday (what a perfect day for your question). We can lift the corners of the lip somewhat with it, but it won't be as much as you are indicating there.