How to fix overhanging lip - hidden smile? (Photos)

Question

Im not sure how to fix my smile - my upper lip overhangs my upper row of teeth. My teeth hence look very small. Before I had lip filler my lips were very thin but you could see my full smile, I don’t want to have small lips again but I’m unhappy with my diminished smile. Should I get a lip lift (Elelyft) or instead look at composite bonding to enlongate my teeth, as I’m unsure if they are just in fact small.

Anna Chacon, MD, FAAD · Answer

Thank you for the detailed explanation—this is a really common concern, and it’s also one where the answer is usually not one single procedure, but figuring out whether the issue is coming from the lips, the teeth, or the balance between both.

From what you’re describing, there are two overlapping concerns:

The upper lip covering too much of the teeth at rest/smile
The perception that the teeth look small or less visible when you smile

These can be caused by different factors, and the treatment depends on which one is dominant.

1. First important distinction: lip vs teeth vs positioning

A “hidden smile” can come from:

Natural lip length or downward lip position
Previous lip filler adding weight or projection to the upper lip
Tooth proportions (short clinical crowns)
Slight maxillary positioning differences (less commonly)

Since you mentioned your smile was more visible before filler, there is a strong possibility that volume in the upper lip is contributing to the overhang.

2. Lip lift (e.g., subnasal lip lift / “bullhorn” lip lift)

A lip lift can:

Shorten the distance between the nose and upper lip
Increase upper tooth show at rest and smiling
Improve lip “roll” and eversion

However, it’s important to be cautious with expectations:

It does not change teeth size
It permanently changes lip anatomy
It can sometimes reduce the natural softness of the upper lip if overdone

A lip lift tends to work best when the main issue is true upper lip elongation at rest, not just reduced tooth visibility from filler-related volume.

3. Composite bonding / veneers (to “lengthen” teeth)

This is often the most overlooked solution.

If your teeth are:

Slightly short naturally
Or not fully exposed due to enamel wear or proportions

Then composite bonding or veneers can meaningfully improve smile visibility without changing your lip at all.

This approach:

Enhances tooth display
Improves smile brightness and proportion
Does not permanently alter facial soft tissue

It’s often the preferred option when the lips themselves are not the primary issue.

4. Lip filler contribution

Since you noticed a change after filler, it’s also important to consider:

Upper lip filler can sometimes create a “heavier” or more projected upper lip
This can reduce upper tooth show, especially in animation or at rest

In some cases, the simplest correction is:

Adjusting or dissolving part of the upper lip filler
Then reassessing the natural lip position
5. What usually gives the most natural result

In cases like yours, the best outcomes often come from conservative, layered decision-making, such as:

First reassess the lip without excessive filler influence
Evaluate actual tooth proportion once the lip is in a neutral state
Then decide if:
lip lift is truly needed, OR
dental enhancement would better restore smile balance
Bottom line

Based on your description, this does not sound like a situation where one procedure is automatically “correct.” Instead, it is about identifying the main driver:

If the lip is truly long or overhanging at rest → lip lift may help
If the teeth are simply under-displayed or short → bonding/veneers may be better
If filler is contributing → adjusting volume may already improve the smile significantly

Often, patients are surprised that improving smile aesthetics does not require changing the lips surgically, but rather restoring balance between lip position and tooth display.

A stepwise approach, starting with soft tissue evaluation before permanent changes, tends to give the most natural and harmonious outcome.

Gary M. Horndeski, MD · Answer

I recommend an eccentric lip lift, not a bullhorn 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.

Carl Truesdale, MD · Answer

The 'hidden smile' appearance happens when the upper lip is long (distance from nostril base to lip vermilion) and covers more tooth than ideal. Two procedures address this from different angles.
Subnasal bullhorn lip lift:The most common solution. A small incision is made under the nose, a strip of skin is removed, and the upper lip is lifted up. This shortens the philtrum (skin between nose and lip) AND increases tooth show at rest and when smiling.
Recovery: 7 to 10 days for visible swelling. Scar hides in the natural shadow under the nose, typically nearly invisible at 6 to 12 months.
Best for: patients with a long philtrum (over 15mm in women, over 18mm in men) and reduced tooth show.
Upper lip reduction:A different procedure that removes a strip of tissue from inside the upper lip (where the lip rolls inward at the wet-dry border). This reduces the vertical bulk of the upper lip itself, making the lip appear less heavy or overhanging.
Best for: patients whose issue is a thick or bulky upper lip rather than a long philtrum.
How to tell which you need:Measure the distance from the base of your columella (between your nostrils) to the cupid's bow of your upper lip. If it's over 15 to 18mm depending on gender, you have a long philtrum and a lip lift is the right tool. If your philtrum is normal length but your upper lip is just thick or heavy looking, lip reduction is the answer.
Sometimes both:Patients with both a long philtrum AND a heavy lip benefit from a combined approach in one session.
What to consider:
The 'no tooth show' appearance is normal aging in many patients &mdash; the upper lip elongates over time and tooth show decreases. Lip lift restores the more youthful proportion.
If you've already had a lip lift and it wasn't enough, a revision with slightly more aggressive resection can be done, but only after 6 to 12 months of healing.
Common mistakes to avoid:
Aggressive lip lift in young patients without true philtrum length issue &mdash; creates an unnatural short upper lip.
Lip reduction by inexperienced surgeons &mdash; can create asymmetry or wet-dry border irregularity.
Best move: see a facial plastic surgeon who does both lip lift and lip reduction. Bring photos of your smile from your 20s if you have them &mdash; useful baseline for what's changed vs always been the case.

How to fix overhanging lip - hidden smile? (Photos)

Answers (3)

More Lip Lift Questions

Do you get more teeth show with a direct lip lift?

Lip lift (1.5 years post) changed my whole face - what can I do to look less pulled across my cheeks? (Photos)

20, male. What lip lift technique and lift amount would best enhance my facial proportions? (Photos)

I hate my philtrum - could lip filler help or would a lip lift be needed? (Photos)

Question regarding VY Lip plasty - would this help my lips to rest together when mouth is closed? (Photo)

Is it possible to horizontally widen lips without significant scarring? (Photo)

WE SEND PRETTY
EMAILS