What method is best for a lip lift? Skin only method or skin and muscle lip lifts? (photos)

Hi! For your guidance, lip lift, or sometimes called as bullhorn procedure, is a minor surgical procedure that shorten the distance between the nose and upper lip which allows more of your central upper teeth to show both at rest and when you smile. The incision is done at the base of the nose, just within the nostrils. It was called bullhorn because of its shape as the muscle is tucked which shortens the skin providing a youthful upper lip in less than an hour under local anaesthetic.
On the other hand, italian lip lift is a modified bullhorn lip lift in which it has a short incision (compared to bullhorn) that creates a similar effect. This procedure has two shorter incisions centered under the nostrils rather than continuing completely across the nose. Do not hesitate to ask your surgeon about detailed information on your options. #RealSelf100

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, and only involves the skin.
The ideal candidate for the Elelyft, or upper lip lift, is someone with a philtral length of 15mm 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.

Gary Linkov, MD
Lip Specialist
Manhattan

Great question . . . and one I hear quite often. My upper lip lift technique involves lifting the lip by excising only skin at the base of the nose. The entire procedure is performed in the office under local anesthesia.I do not believe in upsetting the integrity of those facial nerves or muscles when it's not necessary to achieve the goal of a lip lift. Those muscles act in concert when your mouth is moving to speak, eat, or express your emotions. They act in a complex balance of forces, each one acting independently and contributing to the unique way your facial expression works. The nerves going through the upper lip, where the muscle would be "worked on" adds risk of nerve damage and that potential for nerve damage is too much for my taste.Cutting muscle introduces an added dimension of complexity and risk, which is absolutely unnecessary to achieving fuller, more youthful lips. The lift in a Lip Lift comes from fixing the skin of the lip to the septum cartilage of the nose and the though membrane surrounding the nasal bone openings. It is this fixation that prevents distortion of the nose, thickening of the scar, or migration of the scar.Be sure to consult with board certified plastic surgeons to discuss your specific goals and options, get a detailed description of the surgical technique used by the surgeon, and see several before and after photos of actual patients.Best wishes!

Thank you for your question. The technique I use for a lip lift involves removing the skin only. There is no need to remove any muscle since that may alter movement of the mouth after healing. The incision is hidden in the crease at the junction of the nose and lip, so it is not noticeable after it is completely healed. Sometimes the nostrils can be distorted during the first week or two just from swelling, but you should not have any changes to the shape of the nose in the long term. 
The key to having a good lip lift is removing enough skin and having a balanced lift over the entire length of the upper lip. I have seen many times where a surgeon who has not done many lip lifts will be overly cautious with the amount of skin removed leaving the upper lip still quite long. Even worse, I have seen others where only the mid portion of the upper lip is lifted and not the sides. This will leave a downturned appearance to the mouth or "bunny lips." 
Rest assured, a lip lift done in the right hands is very very attractive which is why it is my favorite procedure.
Best of luck to you,
Sarah Saxon, MD