Will lip filler make a long philtrum worse? (Photos)

Thank you for sharing your photos and your question. I understand your concern. It’s common to notice changes in philtrum length and lip volume as we age, and choosing treatment options can be tricky.

In general, adding filler to the lips doesn’t necessarily make a long philtrum look worse. It depends on how and where the filler is applied. With careful technique, filler can help balance the proportions of the lips and philtrum:

Placing filler strategically in the upper lip, using just enough volume without overfilling, can make a long philtrum appear shorter by slightly lifting the upper lip.

It’s important to avoid placing filler too high near the vermillion border, as this can accentuate philtrum length if overdone.

Since you’ve been managing a gummy smile with Botox, a subtle approach to filler could enhance that and improve thinness without exaggerating the philtrum.

You’re right that a lip lift is another option, but it isn’t always the best fit for everyone, especially if there's a history of a gummy smile. Thoughtful filler application may provide the softness and fullness you want without worsening the proportions of your upper lip.

I recommend starting conservatively, with a provider experienced in balancing lip and perioral proportions. Sometimes, even a small amount of filler in the right spot can make a noticeable difference.

You’re asking all the right questions, showing that you’re thoughtful about your choices. With the right approach, you could achieve a natural and flattering result.

At least from the photos provided, there appears to be signficant lip volume deficit, particularly in the upper lip, which in itself would result in a longer appearing philtrum. Therefore, the use of a medium viscosity HA filler properly injected into the body of the lips can restore lip volume, and in the case of the upper lip, would in itself lend to an apparent shortening of the philtrum. Additionally, a low viscosity, cohesive, malleable HA filler can be threaded along the border of the upper lip vermilion to create a nonsurgical lip lift, which can further improve the appearance of the philtrum. If necessary, a couple of microdroplets of Botox placed on each side of the vermilion of the upper lip can further enhance the lip lift effect. All of the foregoing, in the hands of an experienced, board certified cosmetic dermatologist injection expert can be peformed in about a fifteen minute treatment session with immediate results and little to no significant downtime. Hope this helps and best of luck.

Lip filler can add additional weight and may make the lip larger and decrease the gummy smile. However, you are an excellent candidate for an eccentric lip lift. This does 4 things: shortens the distance between the nose and the 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.

You are definitely a candidate for a lip lift based on your photos. However, to answer your question: lip filler CAN worsen teh philtral height bc it adds weight to your lip that will "drag it down", thus elongating the philtrum.

You are absolutely that you should not have a lip lift with your gummy smile. you can have your lip augmented with a filler and it will add volume to the lips and make your filtro shorter at the same time. Make sure you go to someone who knows how to use the Russian technique in lip augmentation. I hope this helps and good luck from Leonard Grossman, MD, organic Plastic Surgery, New York City.