When to Perform a Lip Lift and When Not To

Let me just get this out of the way: I hate lip lifts. Well not always. I just think they are too often performed creating lips that look unnatural. There are exceptions to this rule but there are very few, which I shall try to elaborate in this blog article. Let’s begin with why do people want lip lifts? The number one reason is a distorted sense of importance imparted to the upper lip for its sign of femininity and youth when in fact the bottom lip can create a much more desirable look without the risk of looking artificial. As I have enumerated in other articles, the upper lip should almost always remain smaller in size relative to the lower lip. When this lip principle is violated, the upper lip can look unnatural. In addition, the upper lip tends to diminish in size as one ages so overlifting the upper lip can look artificial, especially when one is older, which is precisely when someone wants to have a lip lift performed. Again, there is an exception to this rule upon which I shall elaborate.

Lip Lift Gone Bad
Donatella Versace looks as if she is a bad victim of unnecessary lip lift surgery

Let’s also clarify what I am defining as a lip lift:  the incision is made underneath the nose along the border of the nose to the face, and tissue is removed so that the lip can be brought upward and rolled out.  This technique is very effective in lifting the lip but sometimes too effective.  When one takes two fingers and gently rolls the lip upward just a little bit the surgical modification is almost always more than what a finger lift demonstrates.  Therefore, caution should truly be exercised when considering a lip lift.  In addition, there will be a scar:  something a prospective patient must know.  Although with a careful plastic surgery 3-layer closure performed with meticulous precision, this incision should be rarely seen, a patient must know that a scar can be visible close up and that makeup may be needed to camouflage it to an ideal level.  In addition, there can be rarely but still possibly slight distortion to the nasal shape due to some pull on the bottom of the nose but again this is unlikely.  What this article is not talking about is a lip advancement in which the incision is made at the border of the lip and white tissue removed to allow for advancing the red lip upward.  In my opinion this procedure is so fraught with complications including an unnatural shaped lip and visible scar not to mention an overinflated look that there is almost no indication to perform a lip advancement.

Now, when would a lip lift be indicated in a patient then?  Let’s first discuss the aging of the upper lip to have you understand that a lip lift is actually the most intuitive surgical maneuver to correct moderate aging of the upper lip but still may not be ideal in many cases.  The white portion of the upper lip begins to lengthen over time and the red lip begins to become thinner.  This causes the upper lip to hang over the front white teeth with and without smiling, which can be a sign of aging.  The lip lift is actually a very targeted procedure that can correct all three problems:  shorten the white lip, increase red lip show, and show teeth better in smiling and in non-smiling positions.  Intuitively attractive right?  Well yes.  But that does not mean in practicality it always looks good, as it seldom does.

Here is who I have found to be the perfect candidate for a lip lift:  an older woman who has absolutely no upper red lip at all, has a very long white lip, has no upper teeth show when she opens her mouth and when she smiles, has bad surface skin that can hide the scar, and does not mind wearing makeup to cover the scar if necessary.  That is the ideal patient for a lip lift.  The least ideal patient is a young 30-something year old man (or woman) with flawless skin, who has a relatively full upper red lip and relatively short white lip, has good or too much teeth showing when smiling and when not smiling but only wants a little bit more red lip to show.  Unfortunately, most people who want lip lifts fall into the latter category or at least towards the latter category and are truly bad candidates for this procedure because of the risk of visible scarring and an unnatural looking upper lip.  Next time you gently pull up on your upper lip and say that is what you want the physician to do, please heed the cautions enumerated above and think twice.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas, specializing in lip augmentation and lip reduction procedures. To schedule a consultation please call 972.312.8188. To Learn more about Dr Lams’ facial plastic surgery procedures or to ask Dr Lam a question please visit his plastic surgery forums.