As people mature, the philtrum, the space between the upper lip and the nose, naturally tends to lengthen, not shorten, as part of the aging process. A longer philtrum can disrupt overall facial harmony, make the face appear older, and reduce the visibility of the upper teeth when smiling or at rest. This elongation can make the red part of the upper lip (vermilion) appear thinner or seem to “disappear”. Philtrum elongation, combined with loss of volume, collagen, elasticity, bone reabsorption, dental changes, muscle activity around the mouth can make the upper lip appear thinner and invert inwards.
Non- surgical options to treat the mature lip range from treating existing lip lines with Botox or ablative resurfacing lasers and/or injecting dermal filler into the lips to restore volume, define lip borders and smooth lines. Filler adds volume to the lips themselves and does not alter the skin or distance between the nose and lip. Excess filler or improper injection can make a thin upper lip look heavier, which can visually elongate the philtrum.
Sometimes a surgical option to shorten the philtrum, known as the bullhorn lip lift, may be necessary to achieve a patient’s desired facial harmony and balance. The plastic surgeon shortens the distance between the upper lip and the nose which pulls the lip upward, so more pink tissue is visible, which makes the upper lip look fuller and more pronounced. Scarring is discreet and typically hidden by the nostrils. After a bullhorn lip lift, the teeth will also be more visible when smiling. Good candidates for lip lifts include people who want to make their lips look fuller, or those who want their lips to be higher. Those with smaller mouths and broader nasal bases are also considered good candidates.
This procedure is performed under local anesthetic and an oral sedative so fasting is not necessary. After the local anesthesia has taken effect, the surgeon cleans and marks the area. The appropriate amount of skin is excised, and the area is closed with sutures. Any bruising and swelling typically resolves over the course of a few weeks. Sutures are removed one week after the surgery by a post-op nurse.
Ultimately, the decision to shorten the philtrum depends on an individual’s unique facial anatomy and aesthetic goals. Consultation with an experienced, board-certified plastic surgeon is recommended to determine the best approach.
Ready to explore the best approach for your facial harmony? Schedule a consultation with our board-certified plastic surgeon Dr. Kenneth Smith today.
