Lip Lift
All cosmetic surgery involves risks and individual results vary. The outcomes shown in any images on this page are relevant only to the specific patient depicted and do not reflect the results other patients may experience. Cosmetic surgery is a serious decision. Decisions about whether to proceed should be made after careful consideration and following at least two consultations with a qualified medical practitioner.
A lip lift shortens the philtrum — the skin between the base of the nose and the upper lip — by removing a precisely measured strip of skin from just beneath the nose. The vermillion border is repositioned upward, increasing the visible show of the upper lip and sharpening the definition of the Cupid’s bow. The change is permanent. This distinguishes it from lip filler, which adds volume temporarily but does not alter the structural position of the lip.
Dr Roth performs lip lift surgery both as a standalone procedure and in combination with facelift surgery. When the indication is right — a genuinely long philtrum, whether from ageing or anatomy — and the dimensions are planned conservatively, it produces reliable and lasting results. Getting the amount right matters. It is a procedure where conservatism at the first operation is almost always the correct approach.
Cosmetic surgery is a serious decision — read the full lip lift risks page →
Anatomy of the Upper Lip and Why it Changes
A working understanding of upper lip anatomy helps clarify what a lip lift achieves and why it differs from other lip treatments.
The upper lip is composed of two anatomically distinct zones. The white lip (philtrum) is the skin-covered region between the nose and the vermillion border — named for its paler colour relative to the lip mucosa. The red lip (vermillion) is the visible pink or red portion of the lip itself. The Cupid’s bow is the double-curved peak of the vermillion border at the central upper lip, and the philtral columns are the two vertical ridges that run from the nose to the Cupid’s bow peaks, framing the central philtral dimple.
In youth, the ratio between white lip and red lip height is relatively balanced. The typical youthful upper lip has a white lip height of approximately 12–15 mm and shows 3–4 mm of the upper central incisor teeth at rest. The Cupid’s bow peaks sit close to the base of the philtral columns, and the upper lip has gentle upward curvature at its corners.
With age, the white lip lengthens — under the influence of gravity, loss of collagen and elastin in the dermis, and progressive thinning of the orbicularis oris (the circular muscle surrounding the mouth). As the white lip elongates, the vermillion border descends, the red lip rolls inward and becomes less visible, and the Cupid’s bow flattens. The corners of the mouth may descend. The upper teeth show less at rest, contributing to an appearance that many patients associate with the ageing face. This process accelerates in patients with a history of significant sun exposure and in smokers.
In younger patients, some individuals are simply born with a long philtrum — a naturally elongated white lip — that creates the appearance of thin or receded lips without any age-related change. For these patients, a lip lift can meaningfully alter the proportions of the central face.
Lip Lift Versus Lip Filler — Understanding the Difference
The most common non-surgical treatment for upper lip concerns is soft tissue filler injection. Lip filler and lip lift address related but distinct concerns, and choosing between them — or combining them — depends on understanding what each achieves.
Lip filler adds volume to the lip. It inflates the vermillion, increases projection, and can smooth fine lines at the lip margin. It does not shorten the white lip or reposition the vermillion border. Results are temporary, typically lasting six to twelve months depending on the product, and repeat treatments are required. Overfilling is a common aesthetic pitfall — lips that appear disproportionately large, sausage-shaped, or projected beyond the natural anatomy of the face are the consequence of volume added without structural correction.
Lip lift shortens the white lip and repositions the vermillion border upward, permanently changing the lip’s position within the face. It increases the visible red lip without adding volume, enhances the Cupid’s bow definition, and increases upper incisor show. It does not add projection in the same way filler does. Results are permanent.
The two approaches can be complementary. A patient with a long philtrum and thin vermillion may benefit from a lip lift to correct the structural proportions and a small amount of filler to add volume. A patient whose primary concern is volume loss with modest philtrum elongation may be well served by filler alone. Determining the right approach — or combination — is a core part of the consultation process.
What a lip lift cannot achieve: it does not address fine vertical lines above the lip, does not alter the lower lip, and does not correct mouth corner depression (which requires a separate procedure — a corner lip lift or “commissuroplasty”). These distinctions are important in setting realistic expectations.
Types of Lip Lift
Bullhorn Lip Lift (Subnasal Lip Lift)
The bullhorn lip lift is the most widely performed and most reliable technique and is Dr Roth’s standard approach. An incision is made just beneath the base of the nose, following the natural shadow of the nasal sill. A strip of skin is removed in a shape that resembles a pair of bull’s horns — wider in the lateral portions (below the nostrils) and narrower in the central portion. The skin edges are then closed in two layers — a deep layer of absorbable sutures and a superficial layer of fine non-absorbable sutures removed at one week.
The dimensions of the excision are precisely planned before surgery with the patient sitting upright. Dr Roth typically asks patients to use their fingers to gently lift the lip to the position they find most natural and appealing — this gives a direct indication of the desired position and how much skin needs to be removed. On average, 4–6 mm of skin is excised from the central philtrum, with the amount graduated across the width of the excision. The exact dimensions are tailored to each patient’s anatomy and desired outcome.
The resulting scar sits in the natural shadow at the base of the nose, where it is least visible. Meticulous closure technique — using fine sutures, minimising tension, and ensuring precise skin edge alignment — is critical to achieving the finest possible scar. Over six to twelve months, a well-closed bullhorn scar typically becomes a very fine, pale line that is minimally visible in natural light.
Corner Lip Lift (Commissuroplasty)
The corner lip lift — sometimes combined with a bullhorn lift and sometimes performed independently — addresses downturned mouth corners by removing a small triangle of skin at each corner of the mouth. It subtly elevates the oral commissures and can counteract the downward pull of the depressor anguli oris muscle on the mouth corners. The resulting scar at each corner is small and generally well-tolerated, though it is visible on close inspection in the early months. This procedure is considered separately at consultation.
Lip Lift in the Context of Facelift Surgery
A lip lift is frequently performed in combination with a deep plane facelift, and the two procedures complement each other well. A facelift addresses descent in the midface, lower face, jawline, and neck — but it does not directly address the upper lip. Patients undergoing facelift surgery who also have a long philtrum or age-related lip changes often achieve a more complete facial renewal when the lip is addressed at the same operation. The combination adds relatively little to the operative time and recovery compared to performing each procedure separately.
When planning a combined facelift and lip lift, Dr Roth assesses the lip proportions as part of the overall facial analysis at consultation. Not every facelift patient needs or wants a lip lift, but for those with a long philtrum or significant lip show reduction, it is worth considering.
Male Lip Lift
Lip lift surgery in male patients warrants specific mention, as the anatomy and aesthetic goals differ from those in female patients.
In male facial aesthetics, the ideal philtrum is typically longer than in female faces — a shorter philtrum can feminise the male lower face. The Cupid’s bow is less defined, and the upper lip is generally fuller and less arched. Men also tend to have more visible facial hair follicles in the skin of the philtrum, which means the subnasal scar — even when precisely placed — may be less well-concealed than in a female patient.
For male patients, the amount of skin excised is almost always more conservative, the target philtrum height is set at a longer measurement than for female patients, and the planned aesthetic is a subtler, more natural change. These considerations are discussed in detail at consultation for any male patient seeking a lip lift, and the procedure is assessed with particular care in this population.
Are You a Suitable Candidate?
A lip lift may be appropriate if:
- Your philtrum (white lip) is long — either naturally or as a consequence of ageing — and you feel this makes your lips appear thin or receded
- You have had lip filler and feel that volume alone is not addressing your concerns
- You have reduced upper incisor show at rest and would like more natural tooth show
- You are in good general health and a non-smoker (or prepared to stop smoking for a defined period before and after surgery)
- You have realistic expectations about what a lip lift achieves and what it does not
A lip lift is generally not advisable in patients with a very short philtrum, where further shortening would create an abnormal appearance. It is also not the right treatment for patients whose primary concern is volume rather than position, and it does not address concerns below the lip or in the lower face.
Suitability is assessed individually at consultation. Dr Roth takes pre-operative photographs and assesses the philtrum dimensions, Cupid’s bow shape, lip projection, and overall facial proportions before making any recommendation.
Dr Roth’s Clinical Perspective
The lip lift consultation involves one question above all others: is the philtrum genuinely long, and will shortening it improve the proportions of this patient’s face? The answer is not always yes. Patients who present primarily concerned about lip volume — who want more fullness and projection — are often better served by filler or a combination approach than by a lift. Offering a lip lift to every patient who requests one is not good practice. The structural change is permanent and the margin for error is small.
On dimensions: I plan the excision conservatively. The standard teaching is that it is always possible to do more at a second procedure, but you cannot undo an over-resected philtrum. I ask patients to manually lift their lip to the position they find most natural — this is genuinely informative and often produces a target that is more conservative than what patients initially think they want. That is a good outcome. A lip lift that looks operated on, or that eliminates the philtral shadow entirely, has gone too far.
The scar is the other honest conversation. In most patients it fades to a fine line in a well-shadowed position. In some it is more visible — darker skin tones, poor healing, patients who smoke. These are discussed directly at consultation because the trade-off between the improvement achieved and the scar produced needs to be one the patient has genuinely weighed.
— Dr Jason Roth, MBBS, FRACS (ORL-HNS)
The Procedure
In Australia, Dr Roth performs the lip lift under general anaesthesia or deep sedation at an accredited surgical facility. Local anaesthesia alone is possible for a lip lift, but general anaesthesia allows greater precision and patient comfort, particularly when the procedure is combined with other facial surgery.
Surgical markings are made with the patient sitting upright before the anaesthetic, ensuring accuracy of the planned excision. The procedure itself takes approximately 45–60 minutes as a standalone operation. The excised skin is removed, haemostasis is achieved, and the wound is closed in two layers with fine sutures.
Recovery
Recovery from a lip lift is generally straightforward. Most patients find the procedure less uncomfortable than they anticipated.
- Days 1–3: Swelling and mild bruising of the upper lip and base of the nose. The lip will feel tight. Cold compresses help manage swelling. A soft diet is advised.
- Days 5–7: Superficial sutures are removed. Swelling is subsiding; most patients are presentable in a social context. The scar is initially pink and firm.
- Weeks 2–4: Most swelling resolved. The lip settles into its new position. The scar continues to fade.
- Months 3–12: Progressive scar maturation. A well-closed bullhorn scar typically becomes a fine, pale line that is minimally visible in natural light over this period. Silicone gel application and sun protection support scar quality.
Strenuous activity should be avoided for one week. Smoking significantly impairs wound healing and scar quality and must be avoided for a minimum of four weeks before and after surgery.
Frequently Asked Questions
Common questions about lip lift surgery answered by Dr Jason Roth, Specialist Otolaryngologist and Head and Neck Surgeon, Sydney.
Lip filler adds volume using injectable hyaluronic acid — it is temporary (6–12 months), does not change the structural proportions of the lip, and does not shorten the philtrum. It is appropriate when volume is the primary goal.
A lip lift changes the structural architecture of the lip permanently — shortening the philtrum, elevating the lip, and increasing pink lip show. It is appropriate when the philtrum is long and the lip has descended with age, producing a flat or thin appearance that filler alone cannot fully address.
The incision is placed at the junction of the lip skin and the base of the nose — in the natural crease where the nose meets the upper lip. This is a naturally shadowed area and the scar typically fades to a fine pale line within 6 to 12 months. In normal social interaction and in photographs taken from a normal distance, the scar is not apparent in most patients.
Scar quality varies between individuals. Darker skin tones carry a slightly higher risk of visible scarring and this is discussed at consultation.
The amount of skin removed is planned precisely at consultation based on your anatomy, proportions, and goals. Typically 4–5 mm of skin is removed, though this can range from 3 to 8 mm. A normal vermillion-to-nose length is 13–14 mm. A subtle result may be set at 12–13 mm; a more pronounced change at 10–11 mm. The surgeon asks patients to manually lift the lip to demonstrate their desired position.
Swelling and bruising around the lip and nose peak in the first 48–72 hours. Sutures are removed at 5–7 days. Most patients return to work within 7–10 days. Strenuous activity should be avoided for two weeks. The scar is initially pink and slightly raised, fading progressively over 3–12 months.
Yes — a soft or liquid diet is recommended for the first few days to minimise strain on the lip and incision area. Avoid hot, spicy, or acidic foods initially. Avoid using straws as the suction places stress on the healing incision. Good oral hygiene with gentle brushing and antiseptic rinse is important in the first week.
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
View full profile
