Difference Between Types of Lip Lift Surgery?

What's the difference between an Italian lip lift and a Bullhorn lip lift? What are the pros and cons of each type of lip lift procedure?

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Doctor Answers 9

A brief review of lip lift options

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Italian Lip Lift: Two separate incisions beneath each nostril. Skin is removed and the right and then the left lip are each separately lifted by closing the wound and reducing the distance bewteen the lip and nose.

Bull-Horn (subnasal) Lip lift: A single bull horn shaped excision of skin immediately beneath both nostrils shaped like a mini moustache. Closing the wound lifts the right, central, and left portions of the upper lip

Gull-wing (direct) lip lift: A single gull wing shaped removal of skin directly above the red portion of the lip where a woman typically applies lipstick liner.

None of the above 3 lift the corners of the mouth and can actually make them appear to turn downwards even more. Therefore, the above are frequently combined with a corner lift.

Corner lip lift: a triangular or heart shaped excision of skin directly above and to the outside of the "corners" of the mouth to lift and prevent a downturning or frowning appearance.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Italian Lip Lift versus Bullhorn lip lift

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I had not done an italian lip lift, so I looked up the article.

  It looks like a long run for a short slide, as they say in baseball. To avoid cutting under the columella (the small vertical column between the nostrils), the incisions are extended along the side of the columella, then the columella is elevated. This is what allows the central part of the lip to be excised.   Aside from wether the scar is noticeable or not, the real problem is it makes the whole angle between the lip and the columella look kind of funny, especially when viewed from the side.   I like trying new things, but that one is one I'll pass on.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 reviews

Italian vs. Bullhorn Lip Lift

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Thank you for the great question. The Italian lip lift is not a commonly performed procedure, but the general idea is that this technique avoids cutting under the columella (the part of the nose that divides the nostrils). The bullhorn technique is similar but includes the central portion. In my opinion, it is easier to get a natural-appearing curvature of the upper lip with this option.

Bullhorn vs italian

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The Italian lip lift is known to use incisions inside the nose to hide them better but it is limited in that it cannot lift the central lip and sometimes distorts the nostrils. It is not commonly performed and in my opinion it is inferior to the bullhorn (subnasal) lip lift. In the subnasal bullhorn lip lift the incisions are hidden in the shadow under the nose and is difficult to see when healed. Also it also direct elevation of the upper lip. 

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Lip Lift Pros and Cons

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There are different variations on a lip lift. One procedure has the incision avoiding the columella (Italian Lift) and the other and more common is the Bullhorn Lift which has the incision across the nasal base as the incision curves around the columella. The scar from the procedure is quite acceptable and mostly invisible in most patients. The key to this operation is clinical assessment of the upper lip length and the amount of incisoral show. In conversational speech and a mild smile you like to see 1-2 mm of incisoral show. The other consideration is the amount of lifting. It is often necessary to consider at the same time a corner lift of the lip on each side to balance the amount of visible lip show otherwise there is less lip show to the sides of the upper lip after the central part of the lip has been lifted.

Robert W. Sheffield, MD
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 23 reviews

Difference Between Types of Lip Lift Surgery?

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With the Bullhorn or Subnasal lip lift, incision placement is concealed within natural skin creases underneath the nose. With the Italian lip lift, incision placement is concealed within the nostrils. The relative benefit of the Italian lip lift is potentially 'invisible' scars given their placement in a location that is not visible to the average onlooker. The relative disadvantage of the Italian lip lift is that it does not affect the lip distance between the nostrils due to its more limited incision. A hybrid lip lift may be undertaken, sometimes called an 'endonasal lip lift', which conceals a portion of the scar within the nostrils while incorporating a subnasal component to the incision between the nostrils.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 137 reviews

I noticed that different manufacturers have different dimensions for the same cc's

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Great question. My colleagues have explained in great detail the differences in techniques; pros and cons. What I prefer to do in my practice is take variations of these to suit a patient's individual needs. No one person is alike so procedures should be customized to fit the specific needs of the patient.

Kind regards,
Gary Horndeski M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Types of lip lift. What would work for me.

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There are many variations of lip lift techniques. The direct lift above the vermilion is an option that is out of favor today because it interferes with an important anatomical future that is the white line separating the vermillion from the skin and forming the cupids bow. The sub nasal techniques are a much better option. The shape and the size of the incision will depend on the individual patient requirements and the goals that are established after examining the patient. One can plan on lifting the center of the lip more than the sides. In this case the skin excision should be wider in the center and taper off to the base of the nostrils. In other situations, a wider excision is done laterally. A great degree of artistic evaluation is needed to achieve a great result. This is one othe most artistic and rewarding surgeries that I do. You have included a picture and I assume you want to know what needs to be done for this person in particular. It this case an incision going from the base of the alla on one side is made. Then it goes into the nostril, then it continues in the angle between the columella and the lip into the other nostril and then under the other alla. An even amount of skin is taken from the center and the sides to try to maintain the pleasing shape of this lip. This person obviously needs to be evaluated carefully to decide exactly what works for them and how much liting is required, but the person in this picture is a great candidate.

Lip lift and lip reduction surgery in Los Angeles

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A lip lift and/or lip reduction surgery has many variants. The type of lip lift performed depends on the amount of scar risk and the amount of central lip pull required. 

Raffy Karamanoukian MD FACS

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.