Guidance for long philtrum and “smoker’s lines” (photo)

You are an excellent candidate for a lip lift. 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 lines around the mouth of the upper lip will also be improved. Another thing to consider is a circumoral dermabrasion.

Best Wishes,

Gary Horndeski, M.D.

It is very likely that lip lift would create nice improvement in your case. Regarding deep lines, which are result of skin changes as well as volume loss in the lips, options like fillers or fat grafting should be explored. Good luck.

The use of microdroplets of Botox appropriately placed immediately above the vermilion border of the upper lip can help to diminish the underlying muscular action of the muscles surrounding the mouth that are responsible for the so-called "smoker's lines" (aka "lipstick bleeding lines). It will also create a non-surgical lip lift which will secondarily help to shorten the appearance of the elongated philtrum.
The use of a low viscosity, cohesive, malleable HA filler can the be used to elevate and smooth the etching of the overlying "fabric" of the skin that has already occurred. Finally, the same HA filler can be threaded along the upper vermilion to further enhance the lip lift effect and further diminish the appearance of the elongated philtral columns.
You would be wise to make sure to consult an experienced, board certified cosmetic dermatologist filler and Botox injection expert. Best of luck.