An upper lip lift removes a strip of skin under the nose to shorten the distance between the base of the nose and the border of the lip. The result is a lip with more visible border and a smile that shows the upper teeth.
With age, the distance between the nose and the lip lengthens and the upper lip rotates inwards: it looks longer, flatter and with less red showing. At the same time the upper teeth stop showing at rest, which ages a smile in a way that is hard to name but easy to notice.
That change is not corrected with filler. Injecting hyaluronic acid into an already lengthened lip adds volume without shortening anything, and the lip ends up projecting forwards — the "duck lip" look that almost nobody is after — without gaining any visible border. When distance is the problem, the solution is to remove millimetres of skin, not to add product.
It usually helps when there is
- A long distance between the base of the nose and the border of the upper lip.
- A thin upper lip, with little red showing, that does not improve with filler.
- Upper teeth that do not show at rest or on a gentle smile.
- Repeated filler results that leave the lip projected but no more visible.
- Wanting a permanent change rather than a treatment to be renewed.
Worth discussing first if
- A short nose-to-lip distance to begin with: shortening it further produces a forced expression.
- A tendency to hypertrophic scars or keloids.
- Current smoking, which compromises healing in this area.
- Expecting a very full lip: this surgery gives border, not volume.
- Recent nasal surgery, which may make it advisable to wait.
None of these rules the procedure out on its own; all of them change the conversation.
Three different lip operations
They are chosen according to what is missing: distance, border or volume. They are sometimes combined with filler or fat.
Subnasal lip lift
The usual technique. A strip of skin is removed just under the nose, with the scar hidden in the crease at the nasal base. It shortens the distance and rolls out the border of the lip.
Vermilion border lift
Skin is removed directly at the edge of the lip. It gives more border and defines the outline, but the scar is in plain sight, so it is reserved for specific cases.
Augmentation with your own fat
Adds lasting volume when thickness is also missing. It is usually combined with the lift rather than replacing it.
Millimetres, and a scar well hidden
Marking is done with the person sitting up, measuring the current distance and defining how many millimetres to remove: usually between five and eight, rarely more. Overdoing it produces a short lip, with permanent dental show and a tense expression that is recognised at once and has no simple correction.
The scar is designed to follow exactly the contour of the base of the nose — the horn-shaped line that gives the technique its English name — so that it sits hidden in that natural crease. Closure is done in layers, with no tension on the skin: a scar in this area closed tight widens, and here it shows.
What the process is like
From the first consultation to discharge, with the usual timings for this procedure.
Consultation
The nose-to-lip distance is measured, how much tooth shows at rest and on smiling is observed, and it is decided whether the case calls for a lift, for volume or for both.
Before surgery
Basic tests, stopping smoking and any medication that encourages bleeding. The informed consent is signed.
Surgery
As a day case under local anaesthesia. Marking while seated, removal of the strip of skin and closure in layers with a fine suture.
Follow-up
Stitches out at around the fifth to seventh day, and reviews at one month, three months and a year to follow the scar.
Week by week
Functional recovery is quick; what takes months is the scar maturing.
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Days 1 to 5
Swelling of the upper lip, tightness when speaking and a soft diet. The area looks exaggerated during these days.
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Days 6 to 14
Stitches come out. The swelling subsides and the scar is pink and visible: that is its normal phase.
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Weeks 3 to 12
Active care of the scar — silicone, strict sun protection — and massage if indicated. Make-up can be worn.
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Months 6 to 12
The scar finishes fading and flattening. The result on the lip is judged from the third month onwards.
Risks, and what is not promised
The main risk of this surgery is the scar. It goes in a visible place on the face and, although in most cases it matures until it goes unnoticed, it can end up widened, pale or hypertrophic, and that cannot always be predicted. It is the reason why the indication is cautious in skin with a keloid tendency.
Other risks: excessive shortening, with permanent dental show and difficulty closing the lips naturally; asymmetry; temporary altered sensation of the lip; and the general risks of any surgery.
No particular lip is promised, and no invisible scar either. These risks are reduced by a sound indication, closure without tension and strict scar care. They are not eliminated. The ones that apply to your case are explained to you in the consultation and are set down in writing in the informed consent.
The information on this page is for guidance and does not replace an in-person medical consultation. Medical practice is an obligation of means, not of result.
The questions we are asked most about lip lifts
It is designed to follow the edge of the base of the nose, which is a natural crease, and in most cases it matures until it is barely visible from six months onwards.
That said, it is a scar on the face, and that is the real trade-off of the procedure. Anyone not prepared to accept it should stay with the non-surgical options, even though they achieve less.
It is not better: it is a different thing. Filler adds volume; a lip lift shortens distance and brings out border. If your lip is thin but the distance to the nose is normal, filler is probably what suits you.
If you have been adding filler and the lip projects forwards without showing any more, that is the classic sign that the problem was the distance.
It is permanent in the sense that the skin removed does not come back. What does run its course is ageing: the lip will go on lengthening slowly over the years, starting from a shorter distance.
In practice, it is a result that holds well for a long time.
It can, and in fact the area of the incision is next to the base of the nose. But when both operations are being considered together it is worth thinking it through, because a rhinoplasty changes the base of the nose and that moves the reference point for the lift.
In some cases they are done at the same time and in others they are separated by a few months. It is decided in the consultation.
Question not answered here? There are more answers in the frequently asked questions.
