Procedure guide
What a lip lift does, how it differs from filler, and what to expect.
Written by Orr Shauly, MD, plastic surgery resident. Updated .
For information and education only, not medical advice.
The short answer.
A lip lift shortens a long upper lip by removing a strip of skin, most often just under the nose, which shows more of the red lip and upper teeth.1,2 It is the only treatment that shortens the skin of an elongated upper lip, which is something filler cannot do.1 In a review of 17 studies and 2,265 patients, the most common complication was an unfavorable result or scar, at 7.23%, and results were largely maintained beyond 5 years in a series of 52 patients.3,4
- About 19%
- longer with age
- Increase in upper lip length in older vs younger adults on MRI, along with thinning of the lip.5
- 2,265 Patients
- in a literature review
- Patients across 17 studies of upper lip surgery, where 93.6% had a subnasal lip lift.3
- 48.2%
- more lip show
- Average improvement in visible red lip after a 5 mm subnasal lift, largely maintained beyond 5 years.4
Why the upper lip changes with age.
With age, the skin between the nose and the red lip lengthens and the lip thins. On MRI, the upper lip of older adults was about 18% - 19% longer than in younger adults, and markedly thinner.5,6 As the lip lengthens, less red lip and fewer upper teeth show, Cupid's bow flattens and the corners of the mouth may turn down.1,6
Whether the lip also loses volume is debated. One MRI study found volume loss, while another found no loss and concluded that adding volume alone may create an unnatural, overfilled look.5,6 This is why textbooks note that filler alone in a long lip can create a duck-bill appearance.1
What a lip lift is.
A lip lift removes skin from the upper lip to shorten it and roll more of the red lip outward. It is the only intervention that shortens an elongated upper lip skin.1 Lip lifts fell out of favor because of visible scars, but refined incision designs have made them more popular again.1
| Technique | Scar Location | Best Suited For |
|---|---|---|
| Subnasal Lip Lift1,2 | In the crease under the nose | A long central upper lip, often called a bullhorn lift for its shape |
| Corner Lip Lift1 | Along the red lip at the corners | Downturned corners, often combined with a subnasal lift |
| Direct Lip Lift1 | Along the border of the red lip | Precise control of the lip line, usually in patients over 50 |
| Lip Suspension1 | Inside the nose | A no-scar option using a suture, which can also change the nasal tip |
Who is a candidate.
Candidates have a long upper lip with little red lip or tooth show at rest. Ideally about 2 - 3 mm of the upper teeth show when the lips are relaxed and slightly parted.1,2 The subnasal scar hides best in patients with a wide nostril base, a flat philtrum and a well-defined nostril sill.1
Body dysmorphic disorder, unrealistic expectations, active infection and bleeding disorders are reasons not to proceed.1,2 In 202 Asian patients, a long philtrum was often due to orthognathic or orthodontic treatment in younger patients rather than aging, and the lip lift shortened it significantly.7
AI-generated images have been tested as a counseling aid to show patients a realistic preview of a lip lift, a topic the author of this guide has also published on.8,9
How a subnasal lip lift is performed.
- Anesthesia: It is usually done under local anesthesia with an infraorbital nerve block, with sedation if desired.1,2
- Markings: A curved, bullhorn-shaped strip is marked along the crease under the nose, typically 3 - 5 mm high.1,2
- Limit: At least 12 mm is left between the nose and the peak of Cupid's bow so the lip does not look too short.1,2
- Excision: Skin and fat are removed down to the lip muscle, without removing muscle.1,2
- Closure: The wound is closed meticulously in layers with fine sutures.1
Deep plane variations that also lift the lip muscle have been described, with one group reporting design principles from more than 2,440 consecutive lip lifts.10
Recovery.
| Time | What Usually Happens |
|---|---|
| Days 5 - 71 | Sutures are removed |
| First Weeks1 | Bruising and altered sensation in the lip, which can last weeks to months |
| 1 - 3 Months1 | Swelling settles, although it lasted more than a month in 10% of patients |
| Later1 | Some scars are refined with dermabrasion, which one series needed in 20% of patients |
Risks and complications.
| Complication | Reported Rate | Context |
|---|---|---|
| Swelling Beyond 1 Month1 | 10% | 8.3% still had swelling beyond 3 months |
| Thick Scar1 | 5.3% | Some scars are refined later with dermabrasion |
| Undercorrection1 | 2.4% | The lip remains longer than intended |
| Infection1 | 1.6% - 2.1% | Uncommon |
Across 2,265 patients in the literature, an unfavorable result or scar was the most common complication, at 7.23%.3 Overcorrection can show too much of the upper teeth, and any incision crossing the philtral columns makes the scar more noticeable.1
Direct lip lifts carry higher scar risk, with thick scars reported in 3% - 27% and revisions in about 10%, which is why they are usually reserved for older patients.1
Results and how long they last.
In 52 patients who had a 5 mm subnasal lift, visible red lip improved by an average of 48.2%, with 50.1% improvement in those under 5 years from surgery and 40.3% in those beyond 5 years, a difference that was not significant.4 A systematic review found improved lip aesthetics maintained for 12 - 59.1 months across studies.11
A lip lift is often combined with rhinoplasty, and a review of 6 studies and 361 patients reported high satisfaction with mostly mild, temporary scarring and numbness.12
What we don't know yet.
Common questions.
Will a lip lift leave a visible scar?
A subnasal lip lift leaves a scar in the crease under the nose, which usually hides well but can be noticeable in some noses. Thick scars are uncommon, and some scars are refined later with dermabrasion.
Is a lip lift better than lip filler?
They treat different problems. Filler adds volume, while a lip lift shortens a long upper lip and shows more red lip. Adding filler to a long lip can look unnatural, so some patients benefit from both.
How long does a lip lift last?
In a series of 52 patients, the improvement was largely maintained beyond 5 years, with only a slow decline over time.
Can a lip lift show too much of my teeth?
Yes, if too much skin is removed. Surgeons leave at least 12 mm between the nose and the lip line and plan the lift around how much tooth shows at rest.
Is a lip lift done under local anesthesia?
Usually. Most lip lifts are done with a nerve block and local anesthetic, with sedation added if the patient prefers.
Is a lip lift right for me?
Only an in-person evaluation can answer that. This guide is educational and cannot assess an individual case. A qualified plastic surgeon can measure your lip and discuss your goals and options with you.
Key terms.
- Subnasal Lip Lift
- A lip lift that removes skin just under the nose to shorten the upper lip.
- Bullhorn Excision
- The curved, horn-shaped skin excision used in most subnasal lip lifts.
- Philtrum
- The vertical groove in the center of the upper lip between the nose and the red lip.
- Vermilion
- The red part of the lip.
- Cupid's Bow
- The double curve at the top of the upper red lip.
- Corner Lip Lift
- A skin excision at the corners of the mouth to lift downturned corners.
- Incisor Show
- How much of the upper front teeth is visible with the lips relaxed.
Research by Dr. Shauly on this topic.
References.
- 1.Larsen M, Sigal RK. Lip augmentation. In: Janis JE, editor. Essentials of aesthetic surgery. New York: Thieme; 2018. p. 645-75.
- 2.Markelov AM, Austin MB, Burns AJ. Perioral rejuvenation. In: Janis JE, editor. Essentials of aesthetic surgery. New York: Thieme; 2018. p. 528-39.
- 3.Yamin F, McAuliffe PB, Vasilakis V. Aesthetic Surgical Enhancement of the Upper Lip: A Comprehensive Literature Review. Aesthetic Plast Surg. 2021;45(1):173-80. PubMed
- 4.Nagy C, Bamba R, Perkins SW. Rejuvenating the Aging Upper Lip: The Longevity of the Subnasal Lip Lift Procedure. Facial Plast Surg Aesthet Med. 2022;24(2):95-101. PubMed
- 5.Ramaut L, Tonnard P, Verpaele A, Verstraete K, Blondeel P. Aging of the Upper Lip: Part I: A Retrospective Analysis of Metric Changes in Soft Tissue on Magnetic Resonance Imaging. Plast Reconstr Surg. 2019;143(2):440-6. PubMed
- 6.Iblher N, Kloepper J, Penna V, Bartholomae JP, Stark GB. Changes in the aging upper lip--a photomorphometric and MRI-based study (on a quest to find the right rejuvenation approach). J Plast Reconstr Aesthet Surg. 2008;61(10):1170-6. PubMed
- 7.Lee DE, Hur SW, Lee JH, Kim YH, Seul JH. Central Lip Lift as Aesthetic and Physiognomic Plastic Surgery: The Effect on Lower Facial Profile. Aesthet Surg J. 2015;35(6):698-707. PubMed
- 8.Huang RS, Balas M, Yan F, Wulc AE. Use of Text-to-Image Artificial Intelligence Model in Preoperative Counseling for Lip-Lift Procedures. Plast Reconstr Surg. 2025;156(1):47e-50e. PubMed
- 9.Shauly O, Wolmer S. Use of Text-to-Image Artificial Intelligence Model in Preoperative Counseling for Lip-Lift Procedures. Plast Reconstr Surg. 2026;157(4):638e-639e. PubMed
- 10.Talei B, Pearlman SJ. CUPID Lip Lift: Advanced Lip Design Using the Deep Plane Upper Lip Lift and Simplified Corner Lift. Aesthet Surg J. 2022;42(12):1357-73. PubMed
- 11.Júnior LCA, da Silva Cruz NT, de Vasconcelos Gurgel BC, de Aquino Martins ARL, Lins RDAU. Impact of subnasal lip lift on lip aesthetic: a systematic review. Oral Maxillofac Surg. 2023;27(1):9-15. PubMed
- 12.Alnami R, Ahmed S, Alashrah AS, Alasmari T, Alamry RM, Alghamdi HA, et al. Aesthetic and Functional Outcomes of Simultaneous Rhinoplasty and Lip Lift Surgery: A Systematic Review. Cureus. 2024;16(11):e73369. PubMed