What is a lip lift?

A lip lift is a surgical procedure designed to shorten the upper lip as a rejuvenating or feminizing procedure.

Why is a lip lift performed?

Lip lifts are commonly performed in individuals who have a long upper lip.

As people age, the lip tends to lengthen and the red part of the lip becomes thinner. Lengthening of the lip with age also reduces the amount of tooth show both in a resting state and while smiling. The lip lift procedure was designed to counteract this elongation of the lip that occurs with age by surgically shortening the lip.

A lip lift shortens the lip and in doing so, it also increases vermilion show and tooth show. The vermilion is the red part of the lip.

How does lip length change with age? Are there differences in lip length between men and women?

On average, men have longer upper lips than women. Studies have shown the distance between average male and female philtral lengths is around 2mm.(1, 2) The philtrum is the skin of the upper lip between the nose and the vermilion (red part of the lip). One study demonstrated an average philtral distance to be about 18mm in 20 year old men and about 16.5mm in 20-year-old women.(2) This same study showed that philtral length continues to increase with age to an average of 21.5mm in men and 20.0mm in women at the age of 80.

Another study that included individuals between the ages of 20 and 40 demonstrated an average lip length of 20.5mm in women and 22.5mm in men.(1) Note that lip length and philtral length are different. As mentioned previously, the philtrum is the skin of the upper lip between the nose and the vermilion (red part of the lip). Lip length is usually measured from the lowest part of the nose to the lowest part of the upper lip, the location where the lip ends and opens into the mouth.

It is important to note that the numbers above are only averages of a population, they often vary between studies, and they do not take into account ethnic differences.

philtrum length
lip length

What is the difference between a lip lift and lip fillers?

A lip lift is designed to remove skin from the upper lip with the primary goal being to shorten the height of the lip. As secondary effects, patients have more red lip show and more tooth show.

Lip fillers are used to increase the volume of the red part of the lip. Lip fillers do not decrease the height of the lip and sometimes can decrease the amount of tooth show.

 Who is a candidate for a lip lift procedure?

The lip lift procedure is designed to shorten a long lip. This is commonly performed as a rejuvenating procedure to counteract the effects of aging or as a lip feminizing procedure for transgender or cisgender women. The lip lift procedure can be performed in isolation or in combination with other procedures, which is common during facial feminization surgery (FFS).

A lip lift is not recommended for individuals who already have a significant amount of tooth show when smiling, since this can result in an abnormal amount of tooth or gum show after the procedure.

What are the different techniques for performing a lip lift?

There are multiple methods for performing a lip lift, but the most common one performed today is generally referred to as the bullhorn lip lift. This term comes from the fact that the shape of skin removed underneath the nose looks like a bull’s horns.

How is a lip lift performed?

A lip lift procedure is performed by removing lip skin from underneath the nose. The exact amount of skin removed is custom tailored for each individual patient.

The procedure removes only the skin underneath the nose and preserves the normal facial muscles around the mouth.

After the skin is removed, the lip is then elevated and closed with sutures at the lower border of the nose and the lip.

simulation before lip lift
Example image for simulating a lip lift.
lip lift design
If a lip lift were to be performed on this patient, the blue line demonstrates possible markings for a bullhorn lip lift. The skin between the markings would be removed during the procedure.
scar after lip lift
This type of lip lift produces a scar that is hidden at the natural junction of the nose and the upper lip.

How does one prepare for a lip lift?

Lip lifts can be performed in the office under local anesthesia with light sedation or in the operating room under general anesthesia. If the lip lift is performed in the office, you may eat and drink on the day of your procedure. Some people can develop nausea from light sedation.

If the procedure is being performed under general anesthesia, you should not eat or drink anything after midnight on the day of your procedure.

The procedure usually takes around 1 hour to perform, although this may be longer or shorter depending on individual circumstances.

Smoking needs to be stopped prior to the procedure since this can limit appropriate healing from the procedure.

How is the recovery?

Recovery after a lip lift is relatively easy compared to other plastic surgery procedures. There will be some pain following the operation and this will last for a few days. The pain is usually well tolerated with minimal amounts of medication.

There will be swelling of the upper lip following the procedure and it is possible there will be bruising. This can last for a couple weeks.

Since there are no incisions on the inside of the mouth, there is no need to change your diet following the procedure.

Non-absorbable sutures are commonly placed at the surface of the skin. These are usually left in place for 5-7 days prior to removal.

Strenuous activities should be limited immediately following the procedure since this can increase bleeding and swelling of the area.

If possible, patients should try to sleep with their head elevated to reduce swelling of the lip.

Tooth brushing is allowed following the procedure, however there may be more pain when brushing the upper front teeth.

The incision will take time to heal and since it is on the outside of the face and not hidden (such as inside the mouth), there will be a scar underneath the nose. This frequently heals without issue, however, there are scenarios where the scar can become red or develop noticeable scarring.

How long do the results last?

A lip lift procedure permanently removes skin from the upper lip. The face will continue to age over time, but the lip will be permanently shorter.

How much does a lip lift cost?

Lip lift procedures are generally not covered by insurance. The cost of the procedure often varies depending on the surgeon and whether the procedure is being performed in the office or in the operating room.

What are the risks?

The biggest concern when performing or receiving a lip lift is the resulting scar. It is critical for surgeons to respect the natural borders of the face and the close the incision in a way that limits tension on the incision.

Citations

  1. Kolte AP, Kolte RA, Samarth GK. Association of the nasolabial angle and lip length with the gingival and interdental smile line-A gender based evaluation. J Esthet Restor Dent. 2021;33(3):503-9. Epub 2020/09/19. doi: 10.1111/jerd.12657. PubMed PMID: 32945592.
  2. Zankl A, Eberle L, Molinari L, Schinzel A. Growth charts for nose length, nasal protrusion, and philtrum length from birth to 97 years. Am J Med Genet. 2002;111(4):388-91. Epub 2002/09/05. doi: 10.1002/ajmg.10472. PubMed PMID: 12210297.

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