FACESURGICAL
Lip Lift in Murrieta
A lip lift is a surgical procedure that shortens the philtrum, the skin between the base of the nose and the upper lip, so more of the pink vermilion and more upper tooth show when the mouth is at rest. A strip of skin is removed through an incision hidden in the crease beneath the nose, and the lip is advanced upward and closed. The change is structural and permanent, which distinguishes it from injectable lip filler, where added volume is temporary and does not shorten the philtrum.
At a Glance
- In a systematic review of 7 studies and 1,754 patients, bullhorn lip lift shortened mean philtral length from 14.02 mm to 12.03 mm and raised vermilion height from 5.05 mm to 7.01 mm[2]
- Mean patient satisfaction across reviewed studies was 4.4 of 5 on the Global Aesthetic Improvement Scale, with revision rates of 0.6% to 6.7%[2]
- Hypertrophic scarring was reported in 4.6% of cases; no major complications were reported across the included studies[2]
- The incision is placed in the natural crease at the base of the nose, and the procedure typically takes under an hour under local anesthesia[1]
- Over-correction of philtral length can produce an unnatural smile, so the amount of skin excised is planned against the individual's proportions[3]
Overview
The upper lip changes with age. The philtrum lengthens, the vermilion thins and rolls inward, and less of the upper incisors shows when the mouth is at rest. Together, those changes make the mouth appear flatter and longer. A lip lift addresses that proportion by removing skin at the top of the philtrum, raising the vermilion border and increasing tooth show without adding material to the lip.
The subnasal, or bullhorn, lift is the most common technique. A single bullhorn-shaped incision follows the base of the nose and raises the center and sides of the upper lip together. A central lip lift uses a smaller incision focused on the Cupid's bow. The Italian technique places two incisions within the nostril sills for a subtler change. A corner lip lift raises downturned mouth corners, while a gullwing, or direct, lift places the incision along the vermilion border to add definition there.
A systematic review of seven studies involving 1,754 patients found consistent changes in measured lip proportions and high patient satisfaction. With the traditional bullhorn technique, mean philtral length decreased from 14.02 mm to 12.03 mm, mean vermilion height increased from 5.05 mm to 7.01 mm, and mean incisor show increased from 1.51 mm to 3.50 mm. Mean satisfaction was 4.4 of 5 on the Global Aesthetic Improvement Scale.
No major complications were reported across the studies in that review, and revision rates ranged from 0.6% to 6.7%. The review found no single technique superior for every patient. Technique selection follows the individual's anatomic pattern.
What to expect
- Consultation with measurement of philtral length, vermilion height, and incisor show at rest and on animation, plus photography
- Selection of technique based on the anatomic pattern, including bullhorn, central, Italian, corner, or gullwing
- Marking of the planned excision along the nasal base and nostril sills, sized to the intended reduction
- Administration of local anesthesia, or general anesthesia when combined with other facial surgery
- Incision along the marked pattern and excision of the measured skin strip
- Elevation of the upper lip and confirmation of symmetry against the marked landmarks
- Deep layered sutures placed to take tension off the skin edges
- Fine skin closure at the nasal base and nostril sills
- Application of ointment and review of postoperative wound care
- Suture removal and scar assessment at the first follow-up visit
How a lip lift works
- Vermilion show depends on philtral length. When the skin between the nose and upper lip is long, the vermilion sits lower and rolls inward, and the upper teeth remain hidden at rest. Removing skin from the top of the philtrum shortens that distance and brings more of the vermilion border into view.
- The excision follows the base of the nose, with the incision placed in the existing crease and along the nostril sills. That location helps conceal the incision and is one reason the subnasal approach is the most widely used technique.
- Closure advances the upper lip. Deep sutures carry tension so the skin edges meet without pull. The resulting vermilion eversion increases apparent lip height without an implant or injected material.
- The skin is removed rather than stretched, so the shortening does not dissipate as an absorbable filler does. The shortened philtrum remains shortened, although the lip continues to age.
- The amount of skin removed is small, and the margin for error is smaller. Over-shortening can produce an unnatural smile, cannot be undone, and there is no procedure that puts the removed skin back. The excision is therefore planned against the individual's existing philtral length, incisor show at rest, and lip movement rather than a target measurement taken from a study population.
- Lengthening after nasal surgery has a specific anatomic context. The base of the nose and the top of the lip share a junction, and work on one can alter the other. Dr. Banthia also performs rhinoplasty, and he assesses the lip against the nose above it rather than treating it in isolation.
When it's recommended
- A long philtrum with limited vermilion show at rest
- Age-related lengthening of the upper lip and inward rolling of the vermilion
- Reduced maxillary incisor show when the mouth is relaxed
- A thin-appearing upper lip in a patient seeking a structural change without filler
- Upper lip lengthening after prior rhinoplasty or lip surgery
- Downturned oral commissures, addressed with a corner lift
- Asymmetry of the upper lip or Cupid's bow
Is a lip lift right for you?
Reach out to learn more from Dr. Vishal Banthia.
Recovery & aftercare
- Swelling and bruising are expected and largely resolve within about one month
- Many patients return to desk work the next day or within several days
- Strenuous activity is typically avoided for approximately two weeks
- Sutures at the nasal base are typically removed within the first week
- The incision heals as a fine line in the crease beneath the nose and continues to fade over months
- Normal sensation in the lip can take up to six months to return fully
- Initial healing takes roughly 6 to 8 weeks, with the settled result apparent by about four months
Alternatives
- Hyaluronic acid lip filler, which adds volume temporarily and does not change philtral length
- Fat grafting to the lips for volume restoration
- A botulinum toxin lip flip, which everts the upper lip temporarily by relaxing the orbicularis oris
- Vermilion advancement (gullwing) when the goal is definition at the lip border
- Orthodontic or dental treatment when the concern is tooth position or gingival display
- Observation, with the existing lip proportions left unchanged
Related treatments
Frequently Asked Questions
- Dr. Banthia performs the surgical lip lift. He also performs rhinoplasty, so the relationship between the upper lip and the nasal base is assessed together when prior nasal surgery has changed the lip.
- A lip lift removes a strip of skin between the base of the nose and the upper lip to shorten the philtrum. Raising the lip exposes more of the pink vermilion and increases the amount of upper tooth visible when the mouth is at rest.
- A lip lift changes proportion by removing skin. It shortens the distance between the nose and mouth and raises the vermilion border. Filler adds volume to the body of the lip but does not shorten the philtrum. The surgical change is permanent, while filler is absorbed and requires repeat treatment.
- Every lip lift leaves a scar. The incision is placed in the natural crease beneath the nose and along the nostril sills, where it typically heals as a fine line and fades over several months. Hypertrophic scarring has been reported in approximately 4.6% of cases and is a more significant consideration for someone with a history of keloid or thickened scars.
- Swelling and bruising are heaviest during the first week and mostly settle within one month. Many patients return to desk work within a few days and resume strenuous activity at about two weeks. Initial healing takes roughly 6 to 8 weeks, while full sensation in the upper lip can take up to six months to return.
- Shortening the philtrum is a permanent structural change, so it does not fade as an absorbable filler does. The lip continues to age after surgery, and its skin quality and volume continue to change over time.
- A systematic review involving 1,754 patients reported no major complications across the included studies. Minor issues were limited to swelling, bruising, hypertrophic scarring, and temporary altered sensation. Revision rates ranged from 0.6% to 6.7%, mostly for aesthetic refinement. Individual surgical risks are reviewed during consultation.
- A lip lift is generally deferred when the philtrum is already short because further shortening would expose the teeth excessively at rest. It is also deferred for active nicotine users, people with a history of keloid scarring, patients with unmanaged bleeding disorders or anticoagulant use without medical clearance, and anyone with an active infection or inflammatory skin disease at the nasal base.
- The two treatments address different concerns, and only the surgical option is available from Dr. Banthia. Filler adds volume to the lip body but does not change philtral length. A lip lift shortens the philtrum and reveals more of the vermilion already present. Dr. Banthia offers no cosmetic injectables, so a patient with a thin but well-proportioned lip is told when filler is the closer match rather than being steered toward surgery.
- The skin is removed, so the shortening does not dissipate as an absorbable material does. Ageing continues, and the lip changes from its shorter starting point. Before the operation, Dr. Banthia also sets expectations for the scar: a fine line in the crease beneath the nose that is well concealed on most faces but remains a scar on every face.
Lip Lift risks & candidacy
Who should avoid this
- Active infection or inflammatory skin disease at the base of the nose or upper lip
- A history of keloid or hypertrophic scarring, given the visible incision location
- Active tobacco or nicotine use, which impairs healing at the incision
- Bleeding disorders or anticoagulant therapy without medical clearance
- A philtrum that is already short, where further shortening would expose the teeth excessively at rest
- Uncontrolled diabetes or another condition that impairs wound healing
- Goals that the operation cannot meet, identified during consultation
Possible risks
- Visible or hypertrophic scarring at the nasal base, reported in approximately 4.6% of cases
- Asymmetry of the lip or Cupid's bow
- Over-shortening of the philtrum, producing excessive tooth show or an unnatural smile
- Under-correction requiring revision, with reported revision rates of 0.6% to 6.7%
- Temporary altered sensation or numbness of the upper lip
- Persistent swelling of the upper lip
- Bleeding or bruising at the incision
- Infection at the incision site
- Distortion of the nostril sills or nasal base
- Wound separation with tension on the closure
Your practitioner
Dr. Vishal Banthia, MD, FACS
Dr. Vishal Banthia is a double board-certified facial plastic surgeon practicing in Murrieta and Carlsbad, California. He is certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery, and is a Fellow of the American College of Surgeons. His practice is surgical and face-only: facelift, neck lift, eyelid surgery, and rhinoplasty. He lectures internationally, has published peer-reviewed research indexed in the National Library of Medicine, and received the American Academy of Otolaryngology's Humanitarian Travel Award for cleft lip and palate surgery in Honduras.
Sources & references
This article draws on 3 sources, including peer-reviewed research, leading medical institutions.
Medically reviewed by Dr. Vishal Banthia, MD, FACS · Last reviewed: 2026-09-22