Long philtrum: lengthen nose or lip lift? (photo)

I have always been unhappy with the length of my philtrum, which is genetically long. From general research it seems my options are: a rhinoplasty to lengthen my nose (I also have a slightly retracted columella), a lip lift or both. I should mention that when I open my mouth I can see a mm or two of my upper teeth and this worries me that the lip lift will yield unnatural results. What would you recommend in my case? Thank you!

Doctor Answers 14

Be very careful of a lip lift!

I have seen countless patients with lip lifts and i think that procedure on young people - particularly men - gives patients a strange appearance.  And it is not just how it looks in static photos, but also in how their lip looks when they talk and smile. You should be very cautious at your young age about doing a lip lift.  The procedure is great on women in their seventies and beyond, but becomes increasingly problematic the younger the patient is and the thicker and oiler their skin.

Los Angeles Plastic Surgeon
4.6 out of 5 stars 48 reviews


A conservative opinion: It looks good if not better than good.
You have no guarantees on  how a scar will result. It ain't worth the risk.
This is from a guy with over 40 years of private practice experience in plastic surgery.

Dennis Barek, MD
Great Neck Plastic Surgeon
4.4 out of 5 stars 8 reviews

Lip lift to shorten the upper lip and philtrum.

Lip lift to shorten the upper lip and philtrum is a better choice based on my 35 year experience. your retracted columella can be fixed at the same time. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Long philtrum: Lip Lift or Lengthen Nose?

I don't think any surgery on the nose itself would have any effect on the long philtrum. Another way of looking at it is that there is more distance, in skin, from the base of the nose to the lip roll. This includes the entire what we call the "white lip", not only the philtrum.
The long upper lip is a subject that comes up in the surgical treatment of facial aging, because as we age, the upper white lip gets longer (along with other changes around the mouth, like the lower lip and chin dropping and showing the lower teeth, marionette lines or "bitterness folds" at the corner of the lip).
 Many procedures have been proposed and done for this but they have the disadvantage of scars around the lip or under the nose, and if they do not heal perfectly they are visible and detract from the intended effect. One of the worst is a lip lift that places an incision all the way across the lip above the lip roll.
Better and less visible scars are placed in the nostril sill or under the alae (lateral nostril). In the older patient this shortens the white lip and pulls up the vermillion to look more youthful. The closure has to be done with attention to get the least visible scar.  Dr. William Little in Washington, D.C. is a proponent of this technique.
  For a young person with a long upper lip, one would say that either it should be accepted as a natural and unique feature of who you are, or if you are considering surgical shortening of the lip, think long and carefully before doing it, because if the scar turns out less than optimally, it will then be the visible feature of your upper lip, and not the lip itself.  I would personally suggest not doing any surgery on the lip because of these concerns.

Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 48 reviews

Long philtrum: lengthen nose or lip lift?

Dear LWH15, An in office consultation would be needed to assess what procedure should be done if any. A smiling photograph as well as a profile view are also necessary. From the single photograph above I would tell you to leave well enough alone and forego either choice at this time. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Long philtrum: lengthen nose or lip lift

Between those two options, after looking at your photo, I think the lip lift would yield a better result. The retracted columella can be treated at the same time if desired

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews


Thanks for photo.  One with lips parted would be helpful.  Lip lift is an easy procedure to address your concerns. I would not alter nose to achieve this goal.  Lip lifts can be done conservatively with you awake.  That way there are no surprises.  You guide the lift in many ways.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 42 reviews

Reduction of Long Lip Philtrum

The length of the nose at the tip can be increased but not at the base of the nose. A lip lift can be done to shorten your philtrum.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Lip lift

First, you need an in-person exam and evaluation to come up with the best plan.  Generically and from one photo, lengthening the nose would give an undesirable nasal appearance (unless the nose is very short which yours isn't).  A lip lift is your best option.  This involved an incision under the base of the nose and is quite effective.  Seek out a consultation with a board-certified surgeon.  Best wishes.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

Rhinplasty or Lip lift

It is rather difficult to adequately evaluate your nose lenght as well as the consequence of nose lenghtening to the overall aesthetic of your face without a face to face consultation. Certainly, a lip lift is a good option especially if done without a noticeable scar ( which can be done ), and since it will address the cause of the problem straight on.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon
4.6 out of 5 stars 12 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.