I have a philtrum under my bottom lip. What is it, and can I remove it? (photo)

Hello, this is a division or decussation of your orbicularis Oris muscle. That is why when you look back at photographs you see it there most of your life because it is congenital. It just means that muscle didn’t fuse all the way and provided that philtrum which is normally found in the upper lip as you know.
With the restrictions you place on correction the best answer is a filler, I would recommend Bellafill as it is a permanent filler so you don’t have to have repeat injections.

Hello Gabe:

Most of us lose our philtral columns as we age and bemoan our flat upper lips so having it when you were young is not necessarily a bad thing. However, I can see that in the very center yours is a bit deep and I think this is what you don’t like. I’d recommend a temporary rather than a permanent filler because of the changes that can occur with aging. Your doctor will choose a filler that has some lift but is still smooth.

All the best from the Manhattan,

Sheryl Clark MD, FAAD