Same Size for Both Lips During Augmentation?

Do doctors typically make the lips the same size or the upper lip smaller during lip augmentation?

Doctor Answers 9

Lip Size for Purposes of Augmentation

As already correctly noted, the upper lip is generally smaller than the lower.  For purposes of augmentation, this relationship should be preserved.  However, there are anatomic variants and at times, the upper lip may be at least equal in size to the lower.  If the patient so desires, this ratio can be maintained during the procedure.  Generally speaking, making a small upper lip larger than the lower lip is less aesthetically appealing.

Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Lip proportions

We are flooded with images of celebrities' lips, which get our attention because they look odd.  Craniofacial standards suggest that the "normal" proportions of upper to lower lip should approximate 40:60.  That being said, the ability to produce beauty in lip augmentation depends on the patient's anatomy, the injector's aesthetic sense and the presence of scars and prior history of injectables.  Many of my patients have benefitted from subtle volume enhancement with Hyaluronic acid products (Restylane or Juvederm, dealer's choice).  Frequent, small doses allows the patient to resume socializing without being pointed out as a "trout pout" or duck lips.  Although Angelina or Scarlett's lips are desirable, it's important to ensure that a full lip compliments the face, not dominates it.  Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Lip proportions

Some practitioners do make the lips the same size - it depends on which doctor.  Natural lip proportions suggest that the upper lip should be approximately 2/3 the volume of the lower lip.  If the upper lip has too much volume, it begins to resemble a fish-mouth. 

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

Upper lips should always be smaller during augmentation

In fact, the upper lip should be about 1/2 the size as the lower lips to maintain the correct balance within the face. The puckering that you create with lip augmentation should also be very specific. The upper lip puckering should be in the central 1/4 or about an iris width. The lower lip pucker should be about 3 iris widths. The height of the upper and lower lips should be about 1/2 and 1 iris widths respectively.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 84 reviews

Think about the entire face

Lips need to be balanced. The key is to think about not just the size of the lips, but also their position relative to the rest of the face.

As we age, our upper lips get longer in addition to thinner. You need to think about this as getting the upper teeth to show a bit either with a lip lift or with a filler can help you get the results you really want.

It can also be a good idea to bring in a picture of lips you find attractive. While you can't necessarily get that look exactly, your facial plastic surgeon can speak with you about the characteristics you like and work with you towards an excellent outcome.

Jeffrey H. Spiegel, MD
Boston Facial Plastic Surgeon
4.6 out of 5 stars 62 reviews

You must discuss this first.

Most doctors will generally make the upper lip smaller then the lower since that is the normal proportion. That has nothing to do with how much volume is used in each lip. That is determined by the relative size before the augmentation. Very frequently, the upper lip has lost a significant amount of subcutaneous tissue and, therefore, needs significant augmentation. Occasionally, the lower lip needs nothing. Sometimes, depending on patient desires, the two lips may be made the same size, or the upper may be made larger. All this must be communicated prior the any procedure so you and your surgeon are in agreement with what is to be done.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Lips Must Be Balanced

Upper and lower lip balance is essential to natural appearance. Sometimes we see the upper lip slightly dominant in the leading models and other times the lower lip may be slightly dominant. The key is to identify what the natural proportion is for the patient and attempt to simulate that particular balance. There is no clear cut formula and the aesthetic eye and experience of the facial plastic surgeon who is injecting is the key in my opinion!

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.9 out of 5 stars 18 reviews

Depends on the current anatomy and expectations

This depends on the original size of both lips and the patient's request. I find that lip enhancement varies widely between patients. During the initial consultation discussion of expectations and surgical plans should be undertaken. Best of luck!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

The Right Proportion of Upper to Lower Lip Augmentation


Most experienced injectors preserve and enhance your normal anatomy which is a proportion or 30-40% upper lip to 70-60% lower lip.  That being said, each person's lips in relationship to other aspects of their face especially the lips and nose are different.  I often hear of patients saying that they unlike unnaturally full upper and lower lips.  It is best to bring in pictures of lips that you like that fit your facial structure and ask your provider if that is possible to achieve in your face.  During the process of augmentation, have the provider show you what they have done so far to see if it is close to achieving the look you want.  Always remember, less is more.  You can always do more later after you get used to your new look.

Grace Liu, MD
Newport Beach Dermatologic Surgeon
4.9 out of 5 stars 50 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.