I have a long philtrum, would a lip lift or Botox (lip flip) be good options for me? (Photos)

You could opt for both surgical and nonsurgical methods to achieve the goals you have expressed. Injectables like Botox and dermal fillers could produce very good, albeit temporary, results. These procedures do not involve any anesthesia or downtime, but the treatment will need to be repeated to maintain your results. A surgical lip lift would offer a permanent solution. This procedure is usually performed using local anesthesia and a small incision at the base of the nose. Recovery is usually about one week. I recommend scheduling a consultation with an experienced, board-certified facial plastic surgeon for further assessment and treatment recommendations.

A Botox lip flip may give you a sense of what is possible with a surgical lip lift. However, a surgical lift is more powerful and long lasting. I typically include a session of laser resurfacing after surgery to minimize scarring.

Based on the photos it appears that your philtral columns are greater that 15 mm and that would make you a candidate for an upper lip lift. The ideal length should be 11-13 mm. The procedure will provide more tooth show and greater amount of pink.

Cactusgal,

A "lip flip" with botox can make the lip look fuller in some patients, but most patients will see a minimal difference. Botox relaxes muscles, so you need to be someone who is always contracting that muscle and pursing their lips to benefit from relaxing it. It can also may make you unable to whistle or drink from a straw. Botox will not shorten the distance from your nose to your upper lip and it will also blunt some of the nice philtral column definition you have. As we age our upper lip gets longer and will eventually cover our upper teeth, botox won't reverse that either. Filler will actually accelerate the tooth covering process. A lip lift, on the other hand, will shorten that distance, increase tooth show, and roll out the lip making it look bigger. When a lip lift is done properly it will lift the entire lip - even the corners. The trade-off is a scar under the nose. With fair skin and no history of bad scarring I would expect that scar to be hard to find in a couple months, but it will be quite visible for a few weeks. An experienced lip lift surgeon should be able to show you before and after photos as well as photos of the scar at one week, one month, three months, etc., so you have an idea of what to expect. You will have to avoid excess sun on the scar for a couple months, which could be a summer challenge for a cactus gal in MN!

-Dr. Rolfes

I recommend 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.

Best Wishes,

Gary Horndeski, M.D.

i dont find that lip botox helps much for a flip. lip fillers and lift will not help the corners of your mouth, that needs botox, threads or a lip corner lift.  sometimes an early face/neck lift helps. accutite can be a non invasive alternative. I would use daily hydration and plumping (see emeragecosmetics.com lip essentials kit).  everyone can do a little filler when done well really gives nice hydration and plumping.  Best, Dr. Emer.

There are surgical and non-surgical approaches to lip augmentation. Non-surgical approaches include botox (slight lift, reducing gum show) and filler (volume restoration). Surgically, you can have two separate incisions under the nose (italian), one incision under the nose (bull horn), one incision at the red/white upper lip junction (gull wing) or two separate incision at the corners, or a combination, depending on your desired look and anatomy. My preferred surgical technique is called the Elelyft, which is a version of the bullhorn approach. 
The ideal candidate for the Elelyft, or upper lip lift, is someone with a philtral length of 13mm or longer, no upper dental show, and/or a thin upper lip. The nasal base to mouth width ratio needs to be taken into consideration to avoid leaving the lip corners down. 
In your situation, you definitely appear to be a good candidate for a lip lift. The important point is to make sure that the upper red lip to lower red lip ratio stays appropriate. In other words, even though the philtrum is long, it cannot be overly reduced to make your upper red lip bigger than your lower lower red lip. Consult with an experienced lip surgeon for a complete range of options that are appropriate for your situation.
Gary Linkov, MD
Lip Specialist / RealSelf Lip Lift Medical Reviewer
Manhattan

Lip flip is short lived, unreliable, and won't really shorten your mouth.  Lip lift can be done in the office, requires only 20 minutes, and has very reliable results.  Make sure you see someone who does this alot!Watch our videos to learn more.

Hello cactusgal,
First, you have a good lip shape and are correct that you have a long philtrum. Botox "lip flip" is an option but only lasts 3-4 months, will not shorten the length much and will likely not give you the desired outcome. Filler is also an option but again will not shorten the philtrum or increase the height of your upper lip as much as it will bring out. I think you would be a great candidate for a lip lift operation, which would help with your facial proportions as well as give you a fuller upper lip at rest!

HM

 

Hello cactus gal:A lip flip involves injecting only 4 (sometimes 6) units of Jeuveau or Botox into the upper cutaneous lip near the vermillion border. It is not painful and with Jeuveau you will begin to see the results in a day or two. It is easy, safe and inexpensive, and may give you the results you seek. I would consider trying this before having surgery. Stay safe!Sheryl Clark MD FAAD