As popularity in “bigger lips” continues to increase, many Americans wonder what exactly they can do to get their lips to looking bigger, fuller, and more aesthetically pleasing.
And the answer is: there are several options.
Lip fillers are an extremely popular cosmetic intervention that are performed in nearly every part of the United States.
There is also a less widely known procedure called a “lip lift.”
While lip lift surgery is not as popular as filler, it is not an inferior lip rejuvenation technique despite people’s unfamiliarity with it.
Compared to fillers, a lip lift offers a more permanent solution to enhancing and rejuvenating a person’s lips.
There has been a tremendous increase in the number of patients seeking lip augmentation over the past years, and this trend has encompassed all sorts of patient wishes to enhance their lips.
In the beginning of this lip-enhancement craze, many patients wanted their lips to be a big as possible. We’ve seen patients look for the “permanent pout,” “duck lips,” “yo-yo lips,” and more.
In the last few years, patients are trending more towards subtle lip enhancement and wanting to look natural while having subtly bigger lips.
What is a Lip Lift?
The term “lip lift” can be somewhat confusing to some patients, given that there is also the “lip flip” intervention, which uses neuromodulators (Botox or Dysport) to increase the visualized amount of the upper red lip.
In contrast, the lip lift is a surgical procedure used to decrease the amount of “white lip,” creating a more visible, youthful appearing red lip. When thinking about lip anatomy, we can divide the lips into the red and white lip.
The upper white lip actually extends from the top red lip to the bottom of the nose, and then the lower white lip extends from the bottom red lip to the horizontal crease above your chin.
During the lip lift procedure, we remove a portion of the upper white lip to effectively increase the proportion of the upper red lip, which is associated with a younger, more feminine appearance.
Why is Lip Lift Surgery Performed?
From the patient’s perspective, there are two main aesthetic issues that the lip lift can address.
First, an elongated upper white lip is a sign of aging.
If you were to look at a picture of a young lady and compare it with a picture taken 30 years later, you will likely discover that the upper white lip appears longer in the later picture.
It is rare to have a patient come in with their chief complaint being, “my upper white lip is too long.” However, this is something that we subliminally pick up on when looking at people and our brains associate this appearance with aging.
Along similar lines, a longer upper white lip is associated with a more masculine appearance, so reducing it can certainly have a feminizing effect. The volume of the red lip also tends to diminish over time.
Filler is certainly an adjunctive option to enhance the red lip.
Similarly, reducing the size of the white lip gives the perception that the red lip is bigger.
Another consideration is that this offers a permanent solution to lip rejuvenation — this can be contrasted to lip fillers which can have a substantial cost attached to them over time given that they tend to require at least annual injections.
There is only so much vertical height that can be obtained from upper lip filler injections.
Once more and more fillers are added to increase the height of the red lip, we start to see the upper lip being overfilled, leading to the unsightly “duck lip” appearance.
Who Should Get This Procedure?
There are two categories of patients.
The first is the older patient that has age-related elongation of the upper white lip to allow for an appearance that is more consistent with youthful lip proportions (less white lip, more red lip).
The second patient candidate is the younger patient making frequent office visits for lip filler injections. By decreasing the amount of white lip, this gives the appearance of a fuller red lip.
The surgery certainly does not create a contraindication to continued lip filler, but less filler may be needed to arrive at a person’s desired aesthetic appearance.
Does a Lip Lift Leave a Scar?
This is one of the most frequently asked questions by our patients and we certainly recognize the apprehension associated with scars located on the face.
The short answer is: yes.
Anytime we make an incision in the skin there will be a resultant scar.
However, we can hide the incision in the crease along the bottom of the nose. The incision is configured in a curved, somewhat gull-wing, appearance that follows the natural contours of the bottom of your nose.
Once the healing process has completed, this should not be visible. We cannot overemphasize the importance of going to a board-certified facial plastic surgeon to have this procedure, because there are wound closure techniques to ensure that we obtain the most minimal scarring possible.
Upon consultation with our patients, we mutually agree upon the amount of white lip that should be removed.
The amount tends to be around four to six millimeters, but this small amount of tissue removal can make a dramatic youthful appearance for our patients.
During the procedure, we use fine measuring tools called calipers to precisely measure the amount of skin to remove.
An added benefit is that some patients will have preoperative asymmetry of their upper red lip and we can slightly alter the amount of tissue we excise on one side to leave the patient with a more symmetric appearance following the procedure.
How Long Does Lip Lift Surgery Take?
The lip lift is a relatively simple procedure compared to many of the various surgeries we perform daily. You can expect the surgery to last 30 to 45 minutes.
We can perform the surgery as an in-office procedure using local anesthesia or with sedation in our on-site surgery center.
This is decided during the patient consultation. Additionally, the lip lift can be performed concurrently during other procedures that the patient may be having, a facelift, for example.
Either way, it can be done quickly, safely and with minimal discomfort. Some patients prefer to do this in the office to avoid anesthesia while reducing the costs associated with operating room expenses and the presence of an anesthesia provider.
What Is the Recovery Period?
The sutures will remain in place for five to seven days.
We use nonabsorbable sutures because these tend to be less inflammatory compared to the absorbable sutures and avoid leaving permanent marks in the skin.
For the first few days after surgery, you will apply an antibiotic ointment to the incision and then transition to using a product such as Aquaphor or Vaseline to keep the incision well hydrated during the healing process.
The incision should start to be unnoticeable as you approach the second week after surgery. The normal healing process will leave the incision temporarily raised and red, however this can be easily concealed using makeup.
We tend to recommend patients stay home for about two weeks.
However, you could view the current mask-mandate during the COVID-19 pandemic as somewhat of a silver lining given that wearing a mask will offer a convenient opportunity to conceal the incision as you heal.
Although we encourage all patients to wear sunscreen to prevent sun-related skin changes and skin cancer development, it is especially important to protect your healing incision with sunscreen over the next year after surgery to prevent discoloration while the incision fully matures.
You can certainly find pictures on the internet of patients with suboptimal scarring from their surgery likely because of poor surgical technique and excessive wound tension during closure.
Therefore, we have double board-certified specialists at our facility that are experienced and dedicated to solely performing facial procedures.
Schedule a Lip Lift Consultation
At the Plastic Surgery Center at Williams, our specialized surgeons would be happy to schedule a virtual or in-person consultation to discuss a lip lift procedure.
During this consultation, patients can discuss their desired outcome and learn if surgery is the best option to achieve that.
If you have any questions regarding this procedure or would like to initiate a consultation, please give us a call at (518) 786-7000.
To see a lip lift surgery performed (graphic footage), watch this video:
filename: lip-lift-before-after-results.jpg
alt text: two photos side by side of womanwith white hair and gold hoop earrings; the left photo is before undergoing a liplift and the right photo is after recovering
About the Author: Dr. Edwin Williams
Dr. Edwin Williams is a double board-certified facial plastic surgeon who founded The Williams Center in 1993. He has performed over 10,000 facial plastic surgery procedures and has pioneered the deep plane facelift. He served on the Board of Directors for the American Academy of Facial Plastic Surgery for over a decade, and served as President from 2015-2016. In 2016, 2017, 2018 and 2019, Dr. Williams earned the Castle Connelly Top Doctors award in New York Facial Plastic Surgery.
Dr. Edwin F. Williams III attended Cornell University in Ithaca, New York where he received a Bachelor of Science degree in 1982. He began medical school at the State University of Buffalo School of Medicine and received his Doctor of Medicine in 1986.
Dr. Williams is actively involved in teaching facial plastic and reconstruction surgery to the residents of the Albany Medical Center and is former Chief of the Section of Facial and Plastic Reconstruction Surgery at Albany Medical Center where he received an academic appointment of Clinical Professor, Department of Surgery.