Lip Lift – Los Angeles

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

Introduction

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. Lip lifting was designed to counteract this elongation of the lip that occurs with age by surgically shortening the lip.

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

A feminizing lip lift feminizes the face by reducing the excess masculine length of the upper 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.³ 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.⁴ 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.

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

Lip lifting 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 lifting 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. A feminizing lip lift 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.

The best lip lift will be designed in a way that shortens the lip to a length that still appears natural while producing additional show of the red portion of the lip, and creating slightly more tooth show.

Surgery

What are the different techniques for performing a lip lift?

There are multiple methods for surgical lip lifting, 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 surgical lip lifting performed?

A bullhorn 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.

Preparation and Recovery

How does one prepare for the procedure?

Lip lifts can be performed in the office under local anesthesia with light sedation or in the operating room under general anesthesia. If it 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 feminizing 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.

Results

How is the bullhorn lip lift scar?

The incision used to perform the lip lift 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.

The best lip lift scars are placed immediately at the nose-lip junction. By placing the best lip lift incisions in this location, the bullhorn lip lift scar will be hidden at the natural border between the nose and the lip. The best lip lift is performed in a way that prevents the scar from widening with time. It is important to review the results from surgeons to evaluate the usual appearance of the scars they can achieve.

How long do the results last?

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

Frequently Asked Questions

How much does a lip lift cost?

Feminizing 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. The lip will permanently be shorter and there is no easy way to subsequently increase the length of the upper lip. As with all surgery, patients should carefully weigh the risks and benefits of a lip lift before proceeding with the operation.

Does a lip lift change your nose?

The best lip lift should not significantly change the shape or appearance of one’s nose. A bullhorn lip lift does require placing an incision at the nose-lip junction. It is important the surgeon not remove this junction, since that will cause blunting at the nose-lip junction, which looks unnatural.

It is also important that there not be too much tension on the superficial layers of the closure, since this can produce excess tension on the nose, distorting its shape. If too much tissue is removed from the sides of the nose, it may cause the nostrils to widen slightly.

In summary, these changes of the nose do not occur with every lip lift, and the best lip lift should not significantly change the shape of your nose.

How do I find the best lip lift near me in Los Angeles or Long Beach?

The key to finding the best lip lift surgeon is to do your research. It is important for surgeons to have experience with the operation and for them to be able to help you determine whether you are an appropriate candidate for the procedure. There are many plastic surgeons in Los Angeles who are capable of performing a lip lift surgery. The bullhorn lip lift is a common procedure performed during facial feminization surgery for transgender or cisgender women, so it is helpful to seek a surgeon who also has experience with facial feminization surgery.

Before and After Photos

There are multiple aspects to consider when evaluating before and after photographs from surgeons. The overall, first-impression is obviously important in the evaluation. Other items to consider when evaluating lip lift before and after photographs are the location and size of the incision or scar. The incision and scar should be placed at the junction of the nose and lip to hide the scar in that location. One should evaluate the change that is produced in the lip itself. Does the lip still look natural in addition to being shorter? The before and after photographs sometimes show tooth show. Does the amount of tooth show appear natural or is the lip too short and does it make the front teeth too visible?

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. https://pubmed.ncbi.nlm.nih.gov/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. https://pubmed.ncbi.nlm.nih.gov/12210297/
3. 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. https://pubmed.ncbi.nlm.nih.gov/12210297/
4. 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. https://pubmed.ncbi.nlm.nih.gov/32945592/