Extremely tiny lips - Lip filler, lip lift, or surgery ? (Photo)

Question

Hello, My lips became extremely tiny - I have noticed a change last year when people were laughing at me and I didn’t know why, I had 2 lip fillers last year and one this year but the problem is the corners can not be lifted. I need to smile all the time so that my mouth/ lips to appear average. Please advise. Thank you.

Gary M. Horndeski, MD · Answer

I recommend an eccentric lip lift, not a bullhorn lip lift. This 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. This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Steve Laverson, MD, FACS · Answer

Dr. Chacon posted a good answer. As a most experienced aesthetic lip surgeon, my suggestion is to find a great surgeon near you for a combination of commissure adjustment (to reduce or eliminate frown, usually with internal labial mucosal scars invisible from outside) and external custom designed procedure(s) for the vermilion show you want near corners of lips.  Often, serial iterations required so you benefit from and see the effect of each individual treatment.

Anna Chacon, MD, FAAD · Answer

From your description, it sounds like you're dealing with more than just naturally thin lips. The fact that you've already had lip filler several times and still feel that the corners of your mouth don't improve suggests that the underlying issue may involve the anatomy of the lips and the muscles around the mouth, rather than simply a lack of volume.

Lip filler is excellent for adding fullness and enhancing lip shape, but it has limitations. If the corners of the mouth naturally turn downward or the upper lip has become elongated with age, adding more filler can sometimes make the lips look heavier without creating the lift you're hoping for. In some cases, excessive filler may even make the lips appear less defined.

A lip lift is designed to shorten the distance between the nose and the upper lip, allowing more of the pink portion of the upper lip to show. This can create the appearance of fuller lips without relying on additional filler. However, a lip lift primarily affects the upper lip and does not significantly elevate the corners of the mouth.

If the corners of the mouth are the main concern, a corner lip lift is a separate surgical procedure that may be more effective than filler alone. Some people also benefit from small amounts of neuromodulator treatment to reduce the downward pull of the muscles around the mouth, although this depends on the individual's anatomy and is usually a subtle adjustment rather than a dramatic change.

Because you've noticed a significant change over the past year, it's also worth considering whether there have been changes in your facial volume, dental bite, weight, or overall facial aging, as these can all influence how the lips appear.

The most appropriate treatment depends on the cause of the change. If the lips simply lack volume, filler may still be the answer. If the upper lip has lengthened, a lip lift may provide a better result. If the corners are the primary issue, a corner lip lift or other targeted treatments may be more effective than continuing to add filler.

Based on your history of multiple filler treatments with limited improvement, I would be cautious about simply adding more filler without first determining why the lips appear smaller. A thoughtful evaluation of your facial anatomy is much more likely to lead to a satisfying, natural-looking result than increasing volume alone.

Extremely tiny lips - Lip filler, lip lift, or surgery ? (Photo)

Answers (3)

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