Can I still get a lip lift with this amount of tooth show? (Photo)

Question

I have a 15 mm philtrum and am looking for a very conservative lip lift but am terrified i will look like a bunny with too much of my teeth showing. I do believe lip fillers and gummy smile Botox has made my upper lip appear a tad longer. Does the gummy smile and tooth show disqualify me? Thanks

Ritu Chopra, MD · Answer

Yes, you can still get a very conservative lip lift approximately 4 mm. With 4 mm of excision there will be no elevation of your incisive show. I would also recommend tiny bit of fat grafting as well laterally and medially to give you a little more fuller lip without causing any more incisive show.

Anna Chacon, MD, FAAD · Answer

Based on your description, having a 15 mm philtrum does not automatically rule out a lip lift, but your existing tooth show is one of the most important factors to consider before moving forward.

A lip lift shortens the distance between the nose and the upper lip, which increases upper tooth show at rest. If you already display a significant amount of your upper teeth—or if you have a history of a gummy smile—a standard lip lift could make those features more noticeable. That doesn't necessarily mean you aren't a candidate; it means the procedure should be planned very conservatively.

You mentioned that you've previously had lip filler and Botox for a gummy smile. Both can temporarily affect the appearance of your upper lip. Fillers can sometimes make the lip seem longer or heavier, while gummy smile Botox changes how the upper lip moves when you smile. For that reason, it's ideal to evaluate your natural anatomy once these treatments have worn off as much as possible before deciding on surgery.

When assessing someone for a lip lift, I look at much more than the philtrum length. Important considerations include:

How much upper tooth is visible at rest.
How much gum shows when smiling.
The position and shape of the upper lip.
Lip mobility and facial balance.
Overall facial proportions.

If your primary goal is simply to restore a more youthful upper lip without dramatically increasing tooth show, a very conservative lip lift may be appropriate. In some patients, removing only a small amount of skin can create a subtle improvement while maintaining a natural appearance.

Your concern about looking "bunny-like" is understandable, and it's exactly why careful planning is so important. An overly aggressive lip lift can create excessive tooth show or an unnatural appearance, whereas a conservative approach is much more likely to preserve facial harmony.

Ultimately, existing tooth show and prior gummy smile treatment do not automatically disqualify you from having a lip lift. They simply mean that the amount of lift should be individualized and based on a careful evaluation of your facial proportions and lip dynamics to achieve a balanced, natural-looking result.

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. The "bunny look" happens when too much central tissue is taken or not enough lateral tissue is taken. In your case, you may want to take more lateral tissue then central to prevent the "bunny look".

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Can I still get a lip lift with this amount of tooth show? (Photo)

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