Lip lift vs. continued filler

Question

Hi doctors, I’m looking for professional guidance on whether I may be a good candidate for a lip lift versus continuing with upper-lip filler. I’ve had filler in the past and feel that while it adds some volume, I’m curious whether my philtrum length and lip proportions might make me a better candidate for a lip lift.

Anna Chacon, MD, FAAD · Answer

This is a very common and thoughtful question, and you’re asking the right things.

In general, lip filler and a lip lift address different problems, and the best choice depends on anatomy rather than preference alone.

When filler is the better option:
- Your philtrum (distance from the base of the nose to the top of the lip) is already proportionate.
- You mainly want more volume or contour.
- You like the flexibility and reversibility of filler.
- You do not show much upper tooth at rest or when smiling.

When a lip lift may be the better option
- Your philtrum is longer than ideal (often >15–16 mm in women).
- Filler makes the lip look heavier or protrusive rather than lifted.
- You want more tooth show and upper-lip eversion, not just fullness.
- You feel filler has plateaued or changed the lip shape in an unnatural way.

A key concept: filler can make lips bigger, but it cannot shorten the philtrum. In patients with a longer philtrum, adding more filler can actually worsen proportions over time. A lip lift, on the other hand, repositions the lip upward, improving balance and often making the lips look fuller without additional volume.

That said, a lip lift is surgical and permanent, with a scar at the base of the nose (usually very well hidden when done properly). Because of that, I always recommend an in‑person evaluation with precise measurements, profile assessment, and smile analysis before making a decision.

Many patients ultimately do best with:

- A conservative lip lift, then
- Minimal filler afterward, if needed, for fine-tuning

If you’re open to surgery and your measurements support it, a lip lift can be a very elegant solution. If not, conservative, well-placed filler remains a perfectly valid option.

Hope this helps clarify the decision-making process.

Gary M. Horndeski, MD · Answer

I recommend an eccentric lip lift. This 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. This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Stephen Prendiville, MD · Answer

Thank you for the question.  My answer would be perhaps neither,  Ideally, a lip lift is designed for a relatively long lip and relatively small red lip show.  You can make a case for the former but not the latter.  The scar will most likely look good over time, but has a higher chance of hyperpigmentation in the near term.  The purpose of lip filer would be to further volumize the lip, which is possible if performed conservatively.

Lip lift vs. continued filler

Answers (3)

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