Lip Lift

1. What Is a Lip Lift?

A lip lift is a surgical procedure that shortens the distance between the upper lip and the base of the nose in order to:

• Make the upper lip more visible,
• Increase the amount of upper teeth showing when smiling,
• Give the perioral area a younger, more dynamic and often more feminine expression.

The goal is not only to “enlarge” the lip but to:

• Harmonise the nose–upper lip distance with the rest of the face,
• Slightly rotate the upper lip outward so that the red part is more visible,
• Create a more aesthetic, upward-oriented smile.

2. In Which Situations Is a Lip Lift Preferred?

A lip lift is generally preferred when:

• The distance between the base of the nose and the upper lip is disproportionately long,
• The main reason for the upper lip looking thin is not lack of volume, but an elongated skin segment between nose and lip,
• The upper teeth are barely visible when smiling,
• A more permanent, upward-oriented change is desired instead of the “forward bulging” effect achieved only with fillers,
• In the mid–later age groups, where the lower face has elongated with age and started to look “long”.

In some patients, a lip lift may be planned in combination with nose surgery (rhinoplasty) or chin–lip contouring procedures.

3. Who Is a Suitable Candidate for a Lip Lift?

Suitable candidates typically:

• Are in overall good health for surgery,
• Have a long nose base–upper lip distance compared with facial proportions,
• Wish to increase upper lip show but prefer a more upward-rotated, youthful lip rather than a “heavy, forward-projecting” look with fillers alone,
• Understand the possible implications of smoking, scar formation and individual healing characteristics,
• Want a natural but noticeable change in the lips and smile,
• Know that the scar will be hidden under the nose but will not completely disappear, and have realistic expectations.

For heavy smokers, patients with problematic scar history (hypertrophic / keloid scarring) or those unable to comply with local hygiene and care instructions, planning must be more cautious.

4. Facial–Lip Proportions and Aesthetic Balance

When planning a lip lift, the following are evaluated together:

• Upper, mid and lower facial thirds,
• Nasal length and tip position,
• Chin projection,
• Dental show when smiling.

In general:

• The distance between the base of the nose and the upper lip should not be excessively long compared to the distance from the lower lip to the chin.
• When smiling, the upper front teeth should be slightly visible, without excessive gum show.
• If the red portion of the upper lip is rotated slightly upward rather than just pushed forward, the result appears younger and more natural.

Therefore, a lip lift is usually planned considering not only the lips themselves but also the proportions of the entire mid–lower face.

5. Preoperative Evaluation and Planning

Before surgery:

The patient’s medical history, medications, allergies and smoking status are reviewed.

The face and lip area are analysed:

• At rest,
• While speaking,
• While smiling (including photo analysis of the teeth and smile).

The nose base–upper lip distance is measured and compared with the rest of the facial proportions.

Any previous:

• Lip fillers,
• Botox,
• Surgical procedures

are noted.

The patient is informed about:

• How much shortening is planned,
• How much upward rotation of the lip is targeted,
• Where the scar will be located (under the base of the nose, usually along a “bullhorn”-shaped line).

It is also explained that there will be a short-term limitation in speech, smiling, facial expressions and eating during the initial days after surgery.

The goal is to achieve a relatively small but proportion-changing adjustment that delivers a younger and more balanced smile.

6. How Is a Lip Lift Performed?

a) Subnasal (Bullhorn) Lip Lift Technique

This is one of the most commonly used techniques.

Incision planning:

• A marking is made just beneath the base of the nose, following its natural contours,
• Most often a curved line resembling a “bullhorn” is planned.

Skin and tissue removal:

• Within the marked area, a segment of the skin between the upper lip and the nose is removed,
• The underlying tissues are repositioned to gently pull the lip upward and slightly toward the nose.

Closure:

• The distance between the nose base and upper lip is shortened, making the red portion of the lip more visible,
• The incision line is closed with fine aesthetic sutures, and the scar is hidden as much as possible within the natural shadow under the nose.

b) Other Techniques and Combination with Corner Lip Lift

In some patients:

• The mouth corners are downturned, giving a “sad” or “frowning” expression,
• In such cases, a lip lift can be combined with a corner lip lift procedure.

For certain facial types, not only the central part of the lip but also the lateral segments are evaluated for length.

Which technique or combination is appropriate is decided based on lip anatomy, facial expression and the degree of change desired.

7. Anaesthesia Options

A lip lift is most commonly performed:

• Under local anaesthesia with light sedation,
  1. The patient is awake but relaxed,
  2. The lip and area under the nose are fully numbed, so no pain is felt.

If it is to be performed together with more extensive procedures (rhinoplasty, jaw surgery, other facial operations) in the same session:

• General anaesthesia may be preferred.

The anaesthesia type is decided jointly by the surgeon and anaesthesiologist, taking into account the patient’s health status, anxiety level and the scope of the planned procedures.

8. The First Postoperative Days: Swelling, Speaking–Smiling and Perioral Comfort

In the first days:

• Swelling, tightness and mild pain under the nose and in the upper lip are normal.
• While smiling, speaking and eating, a slight pulling or tension sensation is common at first.

During the first 24–48 hours:

• Intermittent cold compresses applied as recommended by the doctor can help reduce swelling.

Typically:

• Mild redness and crusting can be seen along the suture line,
• Pain is controlled with painkillers prescribed by the surgeon,
• It is recommended to avoid exaggerated facial expressions, very wide smiles and movements that overly stretch the lips in the first days.

When eating:

• It is helpful to choose softer, lukewarm foods for the first 1–2 days,
• Very hot, very hard or overly spicy foods should be avoided to increase comfort in the area.

9. Staying in Istanbul, Follow Ups and Returning Home

For patients coming from abroad or other cities:

• A stay of about 2–3 days in Istanbul is usually sufficient to:
  1. Perform the first dressing changes and wound checks,
  2. Monitor swelling and redness,
  3. Decide on the timing of suture removal and explain scar care.

During this period, the patient is informed in detail about:

• How to keep the incision line clean,
• What to watch out for while smiling, speaking and eating,
• Which warning signs require urgent contact with the surgeon (sudden increase in pain, significant bleeding, fever, foul odour, etc.).

On long flights, intermittent movement and adequate fluid intake are recommended to support circulation. For lip lift specifically, there is no major additional risk to the face, but general post-surgery recommendations still apply.

10. Returning to Social Life, Work and Sports

At home:

• Rest is recommended on the day of the procedure,
• From the following day, most patients can perform light household activities comfortably.

Return to work:

• For desk-based, non-physical jobs, most patients can return to work within 3–5 days,
• It should be kept in mind that within the first week there may still be some redness and mild swelling around the incision line.

Return to social environments:

• Within 5–7 days, swelling and redness usually decrease significantly,
• With light make-up and appropriate lighting, the scar becomes much less noticeable,
• It may take a few weeks before the area looks completely as if no procedure has been done.

Return to sports:

• Light walking can be started early, with the approval of the surgeon,
• For intense sports that greatly increase heart rate and blood flow to the facial area, a waiting period of about 3–4 weeks is generally recommended.

11. Scar Appearance, Make-Up and Camouflage

The incision line lies just beneath the base of the nose, along its natural curves.

In the first weeks:

• It appears as a pink–reddish, more visible line.

Over time:

• The colour fades,
• It becomes a finer line,
• It sits within the natural shadows and mimic lines under the nose.

Scar appearance depends on:

• Individual skin type,
• Personal wound-healing characteristics,
• Smoking status,
• Sun protection habits.

Make-up:

• Once the sutures are removed and the skin surface is closed (according to the surgeon’s timing), light make-up can be used,
• Sun protection is especially important in the first months to prevent the scar from darkening (hat, high-SPF sunscreen, etc.).

12. Possible Risks and Complications

A lip lift involves a small area but directly affects facial expression. Like any surgery, it carries some risks:

• Bleeding, haematoma (blood collection under the tissues),
• Infection,
• Delayed wound healing, wound dehiscence,
• Scars more visible than expected (prolonged redness, risk of hypertrophic scarring),
• Asymmetry (slight shift of the lip centre, one side appearing more elevated, etc.),
• Excessive shortening of the upper lip, excessive gum show when smiling (gummy smile),
• Temporary or, rarely, longer-lasting changes in sensation (numbness, tingling).

To minimise these risks, it is critical to have:

• Appropriate patient selection,
• An experienced surgeon who understands lip–nose–teeth proportions,
• Adherence to preoperative recommendations regarding smoking and medications,
• Careful attention to postoperative wound care and follow ups.

All possible scenarios should be explained to the patient transparently before surgery.

13. Results, Expectation Management and Facial Expression

With a lip lift, the goals are to:

• Harmonise the distance between the upper lip and the nose with the rest of the face,
• Make the red portion of the upper lip more visible and feminine,
• Create a smile that shows the upper teeth in a more balanced way,
• Give the face an overall younger, more energetic appearance.

Things to remember:

• In the first 1–2 weeks, the area may be swollen and red; this does not reflect the final shape,
• Within 3–4 weeks, lip shape becomes more defined,
• It usually takes 6–12 months for the scar to mature and look like a natural line belonging to the face.

The most satisfying results are seen in patients who:

• Have realistic expectations,
• Discuss the nose–lip relationship in detail with their surgeon,
• Limit or quit smoking,
• Follow wound-care and follow-up instructions closely.