Are there non surgical options that would minimize my nostril / philtrum visibility and increase upper lip show? (photos)

Question

I have never had any procedures, I am currently being treated with Invisalign for my teeth and bite alignment as I have a slight over bite. I am self conscious regarding the visibility of my nostrils and the philtrum area under my nose, it's very sloped and my upper lip is not visible. I would like recommendations on whether it's possible to make this look better in a non-surgical way? Or is surgery the only option? Thankyou!

Nelson Lee Novick, MD · Answer

Various HA fillers can be helpful for these issues. A medium viscosity HA filler can be used to add volume to the upper lip to bring it into both better proportion and projection with the the lower lip. 
A low viscosity, malleable, cohesive HA filler can be used to better define the vermilion border of the upper lip and which would also help to shorten the appearance of the lower portion of the philtrum. 
Finally, a low viscosity HA filler can be used in the "wings" of the nostrils to help to better mask the lower portion of the exposed columella.
These are all advanced injection techniques that are better left to the hands of an experienced, board certified cosmetic dermatologist filler injector expert and not to novice injectors accustomed to treating ordinary smile lines with simple Restylane or plain Juvederm. Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for your detailed question and the clear photos—both are very helpful in evaluating your concerns.

1. Overview of Your Anatomy and Concerns
Based on your photos and description, it appears that you have:

A sloped philtrum (the area between the nose and upper lip)

Increased nostril visibility on profile

Minimal upper lip show, particularly in repose

These features can be more pronounced due to skeletal structure (e.g., maxillary projection or overbite) and soft tissue configuration. The good news is that non-surgical options may offer some improvement, especially when used strategically and conservatively.

2. Non-Surgical Options to Consider

A. Lip Filler (Hyaluronic Acid)

Goal: Subtly evert the upper lip to increase "lip show"

A small amount of filler in the vermillion border (the edge of the lip) can give the illusion of a shorter philtrum and make the upper lip appear more projected and balanced.

This approach is particularly helpful in patients like you, where there’s no history of previous procedures and anatomy is still structurally stable.

Best results are achieved with microdroplet or tenting technique to avoid bulk.

B. Filler in the Pyriform Aperture or Midface

Carefully placed midface or pyriform filler (around the base of the nose) can adjust the contour of the philtrum and visually reduce nostril prominence, especially when there’s a deficiency at the base of the nose or around the nasolabial area.

This may also slightly lift the base of the nose if there's soft tissue hollowing that enhances nostril exposure.

C. Botox “Lip Flip” (Limited Use Case)

Small units of Botox injected into the orbicularis oris can help evert the upper lip slightly.

However, in your case, since the concern involves structural nostril and philtrum visibility, Botox may have limited benefit and should only be used adjunctively.

3. Limitations of Non-Surgical Treatments

Non-surgical methods can enhance lip projection and subtly shift balance, but they won’t physically shorten the philtrum or reduce nostril height.

If your overbite is contributing to lip recession, orthodontic progress with Invisalign may already be helping gradually. Final facial balance may improve once treatment is complete.

4. When Is Surgery Needed?
If you're seeking a more dramatic or structural change, such as:

Philtrum shortening

Rotation of the nasal base to reduce nostril visibility

Permanent upper lip show correction

…then procedures like a surgical lip lift or nasal base modification may be more effective. These, however, do carry the trade-off of scars (though often well-concealed) and longer recovery.

In Summary:
Yes, non-surgical options exist and can offer subtle but meaningful improvement, particularly with well-placed upper lip and midface filler. These may help balance the proportion between your nostrils, philtrum, and upper lip while you continue with orthodontic treatment. For more permanent or structural changes, surgery may ultimately be needed—but trying conservative measures first is a valid and often effective approach.

Gary M. Horndeski, MD · Answer

Non-surgical options will not be as dramatic.  You are definitely a candidate for surgery.  You would benefit from a chin implant as well as a lip lift and probably a rhinoplasty.  A lip lift 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.  A chin implant will balance your profile.  If you are concerned about your prominent nostrils then this can be resolved at the time of rhinoplasty.

Best Wishes,

Gary Horndeski, M.D.

Are there non surgical options that would minimize my nostril / philtrum visibility and increase upper lip show? (photos)

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Are there non surgical options that would minimize my nostril / philtrum visibility and increase upper lip show? (photos)

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Everything you need to know about Lip Lift

Our mission is to create a world where every investment in modern beauty is Worth It.