Lip Lift: A Guide to Achieving a Beautiful Smile 


Upper lip lift often causes regrets. This article will discuss surgical thoughts, who will benefit from, and designs of bull horn lip-lift with before and after photos.

1. What is a Bullhorn Lip Lift?

The upper lip lift is a surgical procedure that shortens the philtrum and enhances the appearance of a smile. This procedure is also known as the subnasal liplift and is characterized by a bullhorn-shaped excision design.
With aging, the philtrum elongates. So shortening the vertical length of the upper lip can make one look younger.

attractive lip
Beautiful and youthful peri-oral appearance

2. Ideal Philtrum Length

incisor show

The proper position and configuration of the peri-oral area are subjective and influenced by cultural and racial factors. Plastic surgeons and orthodontists have established guidelines about the aesthetics of the peri-oral region.

Orthodontists have determined that the ideal exposure of the upper central incisor should be between 1-3mm when the lips are relaxed.
Plastic surgeons have analyzed peri-oral aesthetics and found that the ideal vertical length ratio for the philtrum to upper lip is about 1.7-2.3:1. The goal of the upper lip-lift is not to fit the length to a strict formula but to create an ideal ratio around the mouth while considering the teeth and lips.

3. Suitable Candidates for a Lip-Lift

A bullhorn lip-lift may be suitable for individuals with a high philtrum-to-lip ratio or those whose upper teeth are not visible during a smile. Dry skin is better suited for this procedure than oily skin, which has a higher risk of scarring.

upper lip lift indications
Indication and contraindication for a lip lift

4. Unsuitable Candidates for a LipLift

Gummy smiles are not ideal candidates for an upper liplift, and this issue should be addressed with Botox injections instead. Individuals with mustaches should undergo laser hair removal before the procedure.

5. Upper Lip Lift Before and After Photos

The following images show the results of a bullhorn lip lift, taken at two weeks, two months, and six months after the procedure. The patient kept their lips relaxed for all images.

Before and after upper lip lift
Before and after surgery

The lip covers the upper teeth in the pre-operative photo, showing the lower one. Post-operative image shows shortened philtrum, and upper teeth are naturally visible. Philtrum-lip ratio looks more balanced too.

6. Bullhorn Lip Lift post-operative management

The upper lip lift procedure is relatively simple, but the most important aspect is to minimize scarring. In some countries, such as Japan, patients are more tolerant of scars, while in others, such as Korea, patients are more concerned with scarring. Factors such as incision design, the surgeon’s skill, skin color, and the presence of sebaceous glands determine scar quality. To minimize scarring, a non-ablative fractional laser and scar relief medication should be used during post-operative management.

Temporal change of the upper lip lift scar.
Temporal change of the scar

As you can see from the picture above, the curvilinear incision scar found in the early stage gets better within 6 to 8 weeks. Laser treatment, medication, and ointment can be helpful, and patients can obtain satisfactory results with strict post-operative care.

7. Conclusion

Traditionally, surgeons have tried to define the ideal face using strict linear measurements. However, this approach is flawed as it assumes all subjects have the same head and facial features. A more accurate and appropriate guide to facial beauty is the “Golden Proportion,” based on the distance between the margin of the upper lip and the base of the nose. The upper lip lift procedure is a secret to beauty when a surgeon can control scar quality, and it is beneficial for both facial rejuvenation and aesthetic proportion. After two months, patients feel natural, as if they had not undergone surgery. When I speak to patients who have experienced an upper lip lift, they often say,

“People tell me I look amazing, but they never suspected I had a lip lift.”

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