Surgical Lip Lift, Botox Lip Flip, or Lip Fillers? What would be best for me?

Question

Dear Doctors, I have struggled with “fish lips” all of my life. My top lip protrudes my bottom one. Causing an unattractive profile and lower self-esteem of my already small shaped lips. I’ve recently noticed that the distance from my nasal base to my top lip is far. I am not sure which procedure would be best, could you advise? Thank you.

Jason Emer, MD · Answer

Pending an in-person consultation, I believe you would get a nice improvement with lip fillers, which can help you achieve the desired fullness, lift, shape and lip balance. NovaThreads can also be used to improve lift and shape. Technique will be important here, so you'll want to see someone meticulous. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Miguel Mascaro, MD · Answer

Thank you for your pictures! Your concerns are valid.  To be honest, if you were sitting here in front of me I would likely steer you towards botox and filler first to see how you like the results.  Because realistically what you are looking for may be further accentuated secondary to anatomy by a surgical lip lift.  Not ot mention that you cant reverse surgery...so better to dip your toes in the water first rather than jump into the deep end of the pool.  I hope some of this helps!

Zoran Potparic, MD · Answer

In your age, based on your photos, injection of hyaluronic acid fillers is the bast treatment to partially augment/shape your lips. However, it requires very skillful person to correct it properly. Good luck.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question and photographs.  Based on your narrative the best treatment would be careful placement of a hyaluronic acid based dermal filler to help you achieve your goals.  This can not only help give the illusion of longer lips by augmenting the corners but can increase the volume of the lower lip relative to the top.  A lip lift or flip will only exacerbate your current concerns.  Hope this helps.

Joseph A. Eviatar, MD, FACS · Answer

Hi,first of all I want to comfort you by letting you know that lots of patients are paying to get your kind of lips.According to your pictures, I want you to know that sometimes  lips don't have equal bone support which could result in uneven balancing between the top and the bottom one, and it looks like you fit in this condition, considering that it looks like that also your chin is not too projected.A consultation with a doctor who specializes in facial injections, whether a surgeon or dermatologist, can explain how to best optimize your smile, your lips, your chin and what would be best to produce a long lasting result that's balanced with the rest of your facial architecture. I would suggest you to start correcting your lips together with the chin (and mental crease) with a filler, in order to make your profile more harmonic.In my practice we collaborate with specialists including cosmetic dentists to provide results that rejuvenate and appear natural.  Often a little neurotoxin, such as botox, can relax certain muscles to create a more ideal lip volume and symmetry.  Combination injection therapy can usually solve the dilemma you are experiencing.  I hope that helps and best of luck.

Shaun Patel, MD · Answer

Based on your photos, I think you are a good candidate for lip filler treatment using an HA filler like Restylane Refyne. I would be concerned about scarring with a surgical lip lift.

Michele S. Green, MD · Answer

From your photos you appear to a be a great candidate for both the lip flip and hyaluronic acid fillers with Juvederm.  You need to have the lips extended with fillers and the top lip "flipped" with Botox.  Please consult an expert in lip injections for the best cosmetic results.  Best, Dr. Green

Pradeep Mettu, MD · Answer

Hi there. With regard to the distance from nose to lip, a surgical lip lift would turn out your the upper lip. Given your concerns about your profile, I wouldn’t consider it at this time as it would make this worse. 
If you are concerned about the horizontal length of your lips - that’s a hard issue to truly address directly as well. However, what I would consider is Botox for masseter (jaw muscle). This makes the muscle smaller and slims the lower face. This would make your lips appear less small. I would also consider Botox lip flip to the lower lip only. This would help address your concerns about your profile. After two weeks, I would reassess and see if filler might help - may help with the profile and may help further address your concerns about having small lips. 
Hope this is useful. Happy to help with this. Ultimately, I encourage you to find a skilled injector you are comfortable with. Wishing you well from Raleigh.

Surgical Lip Lift, Botox Lip Flip, or Lip Fillers? What would be best for me?

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